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I use xylitol in my simple whitening toothpaste and by far the most asked question in the comments of that post is about the safety of xylitol usage. Though it is absolutely not safe (and can even be deadly) to dogs, there is some evidence that it has benefits in humans, especially for oral use.
What Is Xylitol?
Xylitol is a polyalcohol or sugar alcohol found in many fruits and vegetables and extracted from corn or birch wood to make a sweetener that is similar in taste to sugar but with about 40% fewer calories. Even though xylitol is extracted from natural sources, it goes through a process called sugar hydrogenation to become a shelf stable white powder for food and dental use.
Though technically considered a low-digestible carbohydrate, it does not impact blood sugar levels the way sugar does (and this is one of the reasons it is so dangerous to dogs). It can have a laxative effect in humans (more on that below) but it generally considered safe for human use, though it is a FODMAP and can be problematic for some people.
It is widely used in chewing gum, oral health products and as a sugar substitute for those with diabetes or blood sugar related problems. Xylitol is even recommended in the natural health community and is in many anti-candida recipes and diets.
But, is xylitol actually healthy or safe?
Xylitol as a Sweetener?
Xylitol is a somewhat controversial sweetener, but is often promoted as safe for human consumption as a healthier alternative to sugar.
Certainly, I don’t think it is saying much for something to be a healthier alternative to sugar, especially with all the problems sugar can cause, and just because something is considered safe for consumption, doesn’t necessarily mean it is healthy.
I have my concerns with the way xylitol is processed and its long term use for several reasons. It is most often processed from corn, and often genetically modified.
Additionally, since it is not metabolized and broken down in the stomach like other sweeteners, it reaches parts of the intestines that regular sugar wouldn’t. Since it has the ability to kill many strains of bacteria including streptococcus mutans, which is one of the reasons it is beneficial for dental health, it may also negatively affect gut bacteria.
Long-term, this may mean that xylitol could be beneficial for helping with bacterial overgrowth in the digestive system and even with things like biofilms, but it may also mean it can negatively affect beneficial gut bacteria. At the least, this warrants caution and additional research. At the same time, many respected sources take an optimistic approach to xylitol’s potential.
Chris Kresser’s take on them:
For the most part, sugar alcohols cause no appreciable changes in blood glucose or insulin in humans, and sorbitol and xylitol have not been found to raise blood glucose following consumption. (5) In diabetic rats, 5 weeks of xylitol supplementation (as 10% of their drinking water) reduced body weight, blood glucose, and serum lipids, and increased glucose tolerance compared with controls. (6) Two other rat studies also found that xylitol-supplemented rats gained less weight and fat mass compared with control rats, and had improved glucose tolerance. (7, 8)
Interestingly, while research is still emerging, there is some evidence that sugar alcohols like Xylitol can act as a prebiotic and feed gut bacteria (source) which could have both positive and negative consequences for different people. Since they are FODMAP, some people will experience digestive issues from sugar alcohol consumption.
Xylitol has a few potential unexpected benefits:
- It may have the potential to increase collagen synthesis and improve skin strength and smoothness when consumed internally and even to help improve bone density with long term use.
- Studies found that xylitol chewing gum helped reduce ear infections in 30-40% of children who struggled with recurring infections because it helped eliminate bacteria in the mouth that can contribute to ear infection.
It can also cause loose stool, diarrhea and bloating, and many sources recommend working up slowly when consuming sugar alcohols.
Xylitol for Dental Health?
In my opinion, the dental benefits of xylitol are the most studied and the most convincing, especially:
Habitual use of xylitol-containing food and oral hygiene adjuvants has been shown to reduce the growth of dental plaque, to interfere with the growth of caries-associated bacteria, to decrease the incidence of dental caries, and to be associated with remineralization of caries lesions. (source)
By providing fuel for acid-forming bacteria in the mouth, sugar consumption sets up an ideal acidic condition that promotes decay and demineralization of teeth. Xylitol, conversely, is non-fermentable and does not feed acid-forming oral bacteria. Regular use of xylitol causes cavity-forming bacteria, most notably Streptococcus mutans (S. mutans ), to starve and die off by as much as 73%, decreasing the level of acidic byproducts formed when bacteria ferment sugars.24 Xylitol also increases salivary flow which helps to buffer these acids.25 A more alkaline environment is created, leading to less tooth decay and plaque, and enhanced tooth remineralization. Untreated cavities, especially small decay spots, can harden and become less sensitive from exposure to xylitol.26
My dentist suggests Xylitol chewing gum for helping avoid cavities, but since I don’t like chewing gum for several other reasons (I explain in this post), I like to use it in toothpaste instead.
Important: Xylitol and Dogs
Though it is considered safe for humans, it is extremely toxic to dogs and other pets:
In both humans and dogs, the level of blood sugar is controlled by the release of insulin from the pancreas. Xylitol does not stimulate the release of insulin from the pancreas in humans. However, when non-primate species (e.g., a dog) eat something containing xylitol, it is quickly absorbed into the bloodstream, resulting in a potent release of insulin from the pancreas. This rapid release of insulin results in a rapid and profound decrease in the level of blood sugar (hypoglycemia), an effect that occurs within 10-60 minutes of eating the xylitol. Untreated, this hypoglycemia can be life-threatening. (source)
Even a very small amount of xylitol can be deadly, especially to small dogs. In fact some brands of gum contain enough xylitol that even a single piece could be lethal to a dog.
Many people are understandably opposed to even having xylitol in the house with pets and caution should be used to keep any xylitol containing products (gum, toothpaste, etc) out of the reach of pets.
My Take on Xylitol
With the current research, I would only ever consider using a Xylitol from birch wood in homemade oral health products like:
Until more research emerges, I don’t feel comfortable using it as a sweetener in food, though many people do. I prefer to use options for sweeteners like allulose, monk fruit, or stevia.
This article was medically reviewed by Dr. Scott Soerries, MD, Family Physician and Medical Director of SteadyMD. As always, this is not personal medical advice and we recommend that you talk with your doctor.
What’s your take? Do you use Xylitol? Share below!
Discussion (45 Comments)
I’m happy to have read this article and realize I’m not crazy. In my search for an alternative sugar I tried xylitol a few times in small amounts because I wasn’t sure. It gave me severe stomach cramps and diarrhea for days! I don’t’ use it any more. I never heard of it for dental use.
me too, i never had such pain in my intestines never ever.
My dentist was in the Navy and he said that they would hand out large amounts of Xylitol chewing gum to the seaman on the submarines to prevent cavities. He also recommended giving to my kids who are 3 and 6. I have Xylitol toothpaste for them as well.
I use it as a sweetener also, I have the NOW packets with Stevia added. Also, stevia is not made from corn by the way.
I’d like to comment on Rene’s post. The studies in Finland are based on the consumption of Xylitol in Finland during WW11 when sugar was unavailable. Xylitol has been used in Finland for 70 years and has been found helpful in preventing cavities and respiratory health through use of xylitol nasal spray. You can find more information on http://www.xlear.com.
I’ve been doing quite a bit of research on xylitol myself, after using small amounts of it for a short time and seeing an improvement in systemic candida. Here are a couple of things I learned.
1. Researchers in Finland conducted numerous studies on xylitol in the 1970s. These studies, done over a period of years, were published in the late ’70s (search PUBMED for specific ones) and came to be known as the Turku Sugar Studies, because they originated at Turku University in Helsinki. Generally, these researchers found that xylitol consumption was safe in large amounts (70 g per day or more) and provided a profound increase in oral health. For my part personally, I find that it is not necessary to consume large amounts of this stuff to get a good result, if what you’re after is greater health. I don’t know how someone who is diabetic and sweet deprived might feel. The human body actually makes xylitol, so it can’t be considered a foreign substance, but I can see how too much might lead to a case of diarrhea. One can also get diarrhea from eating too much fructose!
2. The fact that xylitol breaks up oral biofilms has led some researchers to investigate whether xylitol can be used to treat biofilm infections in chronic wounds. Randy Wolcott, a doctor who runs the Southwest Regional Wound Care Center in Lubbock, TX uses a combination of xylitol, lactoferrin (a protein found in milk and saliva that kills bacteria by taking their iron away), and an extract of witch hazel bark to treat diabetic, non-healing wounds. He says his patients have seen good results, in contrast to conventional therapy, where different drugs are tried one at a time. According to Wolcott, xylitol “has powerful antibiofilm properties” so perhaps we will be seeing more and more trials of xylitol treating different conditions as time goes on. (An interview with Randy Wolcott can be found at bacteriality.com.)
I think your toothpaste is super, and so do other members of my family. The Finnish researchers noted that xylitol had remineralizing effects on teeth. Given that and the fact that it makes the toothpaste taste good, I say go for it.
I have been trying your remineralizing tooth powder but not the toothpaste yet. I also use the InVitamin tooth powder with activated charcoal. Is the remineralizing tooth powder as beneficial as the toothpaste? I am trying to strengthen my teeth and reverse cavities if possible. So can you say if the powder is as useful as the paste? I also use the powder together with the Ora Wellness Healthy Mouth Blend.
Also, is the calcium content in the powder or paste enough for remineralizing, or do you think a calcium supplement is also needed? I am taking the Green Pasture butter/cod liver oil blend, plus Vitamin D and a chelated magnesium supplement. Thanks so much for providing your perspective and thoughts.
I am new on this blog or whatever it is and am not familiar with AIP. Since I suffer with IBS I wondered if it was something that would help me? As far as I know I have no thyroid problems. Thanks for your help.
Katie - Wellness Mama
AIP is a protocol that I used to help with my autoimmune disease… I explain more about it here.
Thank you for this article. Very informative. What sweeteners do you use or would you recommend as an alternative sweeter?
Thanks for info, I use stevia and I heard it’s also made from corn. Is this safe? Thanks!
Stevia comes from the stevia plant. And if you buy pure stevia, that is what you get. However, if you buy Truvia or some other similar product, then it will contain erythritol and stevia (and I think maltodextrin and other additives) Erythritol usually comes from corn (maybe exclusively, even.) If you want to avoid the additives and erythritol, then I suggest looking for pure stevia or pure stevia extract. I persoanlly use Now Organic Better Stevia (UPC 73373906980) Its a liquid sweetener that you add droplets to food/drink.
Stevia comes from a plant. I actually had a Stevia plant that I took leaves from to put in iced tea as a garnish. It tasted sweet!
Oh my!!!!!!! That’s scary! I didn’t realize that Xylitol is deadly to animals!! Thank you for the info!
HI Wellness Mama!! I just love your site and all your wonderful recipes and info….thanks for all you do! I must confess, I was unaware of FODMAP until now! I have been following AIP because of thyroid issues and have been using coconut oil and milk in almost everything and occasionally xylitol in gum and mints. I do not suffer from IBS symptoms while on AIP, but I haven’t been losing any weight either. I feel better overall following AIP, but wonder if some of the FODMAP I have unknowingly been substituting, could be stalling my weight loss efforts?! Any thoughts???
Katie - Wellness Mama
It could? This is all part of the guessing/detective game of your own health.
Could you elaborate on what AIP is? I have had some issues with indigestion, bloating, etc., which is sometimes made better when I take digestive enzymes with my meal. I understand that there are some carbohydrates that some individuals can’t digest completely and then they ferment in the gut. I have looked at some lists of high/low FODMAP foods, but I’m curious to know if there is a diet that will actually improve the condition or if we just have to eliminate eating certain foods?
This might help: https://wellnessmama.com/22689/autoimmune-diet/
Thanks, I appreciate it!
It sounds daunting having to eliminate so many foods. It sounds like I need to base my diet mainly on vegetables and meat, but these are often challenging to carry around without refrigeration. I seem to be able to eat raw celery and carrots without problems, but raw sugar snap peas give me gas. (I guess that peas would be considered a legume and need to be avoided anyway?) I had a readymade raw kale salad that I purchased while I was out which gave me so much pain, cramping and bloating that I was doubled over. I’m not sure if it was the raw kale or that and the combination with the salad dressing which might have had gums in them?
I know that I should avoid most “processed” foods. I seem to be reacting to a lot of the “gums”; gellan gum, guar gum, xanthan gum, etc., which also cause excess mucus in my colon. They are used as emulsifiers or to create a better “mouth feel.” It’s hard for me to figure out if I’m reacting to only some or all because there are often multiples in a single product.
I’m not trying to lose weight; at 5’7″ & 120 lbs and relatively fast metabolism, I need to work to maintain my weight and energy level. I have an irregular schedule, like to have snacks that I can bring with me and realize that I rely upon A LOT of the avoid foods like; nuts, seeds, grains, yogurt, cheese, eggs, etc., Will explore dehydrated veggie chips. Is corn considered a grain or a vegetable? Any substitutes for hummus? Do you have any suggestions on other portable foods like jerky, dried seaweed, etc.,?