Erythritol, platelets and clotting potential in healthy volunteers
What it found
In healthy volunteers, drinking 30 g of erythritol made platelets stickier and release more clotting signals, while the same amount of glucose did not.
This was a small study of 10 people per group.
What they found
Studies in people
Erythritol blood levels
After drinking 30 g of erythritol, blood levels rose more than 1000-fold, from about 3.8 to 6480 micromoles per litre. Glucose had no effect on erythritol levels.
Platelet clumping
Erythritol increased platelet clumping in response to ADP and TRAP6 in every volunteer tested. Glucose did not increase platelet clumping.
Clotting signals released
Erythritol increased the release of serotonin and CXCL4 from platelets when triggered by ADP or TRAP6. Glucose did not increase the release of either marker.
Short-term only
The study only looked at platelet function 30 minutes after drinking erythritol. It did not test what happens over days or weeks.
What the authors conclude
“Ingestion of a typical quantity of the non-nutritive sweetener erythritol, but not glucose, enhances platelet reactivity in healthy volunteers, raising concerns that erythritol consumption may enhance thrombosis potential.”
Also in their conclusions
- They say that a typical serving of erythritol enhances platelet reactivity in healthy volunteers, raising concerns that erythritol consumption may enhance thrombosis potential.
- They suggest that discussion of whether erythritol should be reevaluated as a food additive with the Generally Recognized as Safe designation is warranted.
- They advise that further studies exploring the cardiovascular safety of sugar alcohols like erythritol as a sugar substitute, particularly among subjects at heightened thrombosis risk, seem prudent.
How it was done
The authors had previously found that higher blood levels of erythritol were linked to heart attacks, strokes and death, and that erythritol made clotting more likely in lab tests and animals. They wanted to test directly whether eating erythritol affects platelet function in people.
They gave 10 healthy volunteers 30 g of erythritol and 10 others 30 g of glucose, mixed with water. Blood was taken after an overnight fast and again 30 minutes after drinking the mixture, and platelet clumping and granule release were measured.
What it can’t tell you
- The study was small, with only 10 people in each group, so the results need to be repeated in other groups.
- It only measured platelet function 30 minutes after drinking erythritol, so it cannot show what happens with long-term use.
- It cannot prove that erythritol causes heart attacks or strokes, only that it changed platelet behaviour in the short term.
Who paid
- Funding
- Funded by NHLBI NIH HHS (from the PubMed record).
- Conflicts
- S.L. Hazen and Z. Wang report being named as coinventors on pending and issued patents held by the Cleveland Clinic relating to cardiovascular diagnostics and therapeutics, all unrelated to the subject and contents of this article. S.L. Hazen and Z. Wang also report having received royalty payments for inventions or discoveries related to cardiovascular diagnostics or therapeutics from Procter & Gamble and Cleveland HeartLab, Inc, a fully owned subsidiary of Quest Diagnostics. S.L. Hazen is a paid consultant at Zehna Therapeutics, has received research funds from Zehna Therapeutics, and is eligible to receive royalty payments for inventions or discoveries related to cardiovascular diagnostics and therapeutics from Zehna Therapeutics. W.H.W. Tang reports being a consult at Sequana Medical A.G., Cardiol Therapeutics, Zehna Therapeutics, Genomics plc, Boston Scientific, WhiteSwell, Bristol Myers Squibb, Intellia Therapeutics, Alexion Pharmaceuticals, Alleviant Medical, CardiaTec Biosciences, Salubris Biotherapeutics, BioCardia, and has received honoraria from American Board of Internal Medicine, Belvoir Media Group, and Springer Nature. The other authors report no conflicts.
- Authors work at
- Lerner Research Institute M.W., S.L.H.; German Heart Center of Charité, Germany (M.W.); Vascular and Thoracic Institute W.H.W.T., OH
The paper
- Title
- Ingestion of the Non-Nutritive Sweetener Erythritol, but Not Glucose, Enhances Platelet Reactivity and Thrombosis Potential in Healthy Volunteers-Brief Report
- Type
- Clinical trial
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Witkowski M, Wilcox J, Province V, et al (2024). Ingestion of the Non-Nutritive Sweetener Erythritol, but Not Glucose, Enhances Platelet Reactivity and Thrombosis Potential in Healthy Volunteers-Brief Report. Arteriosclerosis, thrombosis, and vascular biology. doi:10.1161/ATVBAHA.124.321019Free full textPubMed 39114916DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error