Erythritol, blood clotting and heart risk: what the evidence shows
What it found
In people, animals and lab tests, the evidence does not clearly show that eating erythritol causes blood clots or heart problems.
Some studies hint at a link, but others do not.
What they found
Studies in people
Blood clots in people
People with rare inherited conditions that cause erythritol to build up in the body do not show more platelet activation or blood clots. Some of these patients actually have bleeding problems, not clotting problems.
People with diabetes
In one 4-week study, people with type 2 diabetes who ate 36 grams of erythritol a day had less arterial stiffness and better blood vessel function. The study had no control group and was not blinded.
Animal and lab studies
Long-term animal studies
Most long-term studies where animals ate high levels of erythritol found no signs of platelet activation or increased clotting. Some studies even found longer clotting times, meaning less clotting.
Injected vs eaten
One mouse study found faster clotting after erythritol was injected directly into a vein. But this does not match how people consume erythritol, and the injection may have caused a fluid shift that activated platelets.
Lab tests on cells
Some lab tests found erythritol increased platelet activation and clotting, while others found it protected blood vessel cells from damage. Results depend on the type of cells and what they were compared with.
Studies in people and animals
Erythritol as a marker
High blood erythritol may simply be a sign of poor blood sugar control or a high-sugar diet, not a cause of heart problems. In one study, elevated erythritol was detected up to 20 years before diabetes diagnosis.
What the authors conclude
“Until supportive data from these trials are available, it cannot be concluded that dietary erythritol promotes platelet activation, thrombosis, and cardiometabolic risk.”
Also in their conclusions
- They say it cannot be concluded that dietary erythritol promotes platelet activation, thrombosis and cardiometabolic risk until supportive data from clinical trials are available.
- They advise that clinical trials examining the long-term effects of erythritol consumption on cardiometabolic outcomes are required to test causality.
- They suggest erythritol may be merely a marker of metabolic dysregulation caused by impaired glycemia, but this needs further examination.
How it was done
Some studies found that people with higher levels of erythritol in their blood were more likely to have heart problems. One team suggested erythritol might make blood clot more easily, so the authors looked at all the evidence to see if that holds up.
They searched for all studies on erythritol exposure that reported blood vessel or heart outcomes. These included studies in people, animals and lab tests, as well as reports of rare inherited conditions where erythritol builds up in the body.
What it can’t tell you
- Most of the evidence comes from animals and lab tests, which cannot show what happens in people.
- The studies that followed people over time can show a link between erythritol levels and heart problems, but not that erythritol caused them.
- There is almost no clinical data on the long-term effects of eating erythritol on heart and metabolic health in people.
Who paid
- Funding
- Funded by NHLBI NIH HHS (from the PubMed record).
- Conflicts
- In 2020, K.L.S. was contracted and paid $12,000 by Amyris Inc. to write reviews of the scientific literature about erythritol and other topics for their internal use. In fall 2021, K.L.S. requested and received approval from Amyris Inc. for expanding and updating the original erythritol review for publication [3]. T.A.M. declares no conflict of interest.
- Authors work at
- King Saud University, Saudi Arabia; University of California, USA
The paper
- Title
- Elevated Erythritol: A Marker of Metabolic Dysregulation or Contributor to the Pathogenesis of Cardiometabolic Disease?
- Type
- ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
- Evidence
- Studies in people · animals · lab
- Summarised from
- Full text
- Cite
- Mazi TA, Stanhope KL (2023). Elevated Erythritol: A Marker of Metabolic Dysregulation or Contributor to the Pathogenesis of Cardiometabolic Disease?. Nutrients. doi:10.3390/nu15184011Free full textPubMed 37764794DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error