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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 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)
and
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!
I’ve been consuming a lot of xylitol mints for dental health. I started having headaches, dizziness, nausea, fatigue and heart palpitations. The light bulb in my head finally went off when I realized this happens to me after popping a bunch of xylitol mints. I’m relieved that is all it is because I was starting to think I was dying or something was seriously wrong with me. It’s really a shame because it did such wonders for my teeth.
After spending a great deal of time trying to find alternatives to sugar ,being a type 2 diabetic and not ever getting used to the idea of not having sugar in my tea or coffee caffeine free of course I now find xylitol a great alternative and I find no ill effects from it although I do not ingest much to make the difference but the idea of having slightly loose stools is a better option to using sugar in any form and of course there is the bodies craving aspect surely the use of xylitol helps that aspect long term.
I have been researching different types of sugar alcohols; erythritol, xylitol, sorbitol, etc., because I have some troublesome symptoms when I consume them in large quantities in food. It’s not exactly diarrhea, but I get copious amounts of mucous in my colon that then leaks out. (sorry to be so graphic, but hope that this helps someone else who is also experiencing this) I don’t know if this is simply because of the osmolality; that it increases the flow of fluid into the colon to balance out the minerals or if it’s an allergic reaction? I do not know if it’s simply an annoying side effect or if my colon is actually inflamed or damaged in the process?
I first noticed this when eating a specific brand of protein bar that used erythritol as a sweetener. Then I noticed a similar reaction from a chewable enzyme that contained sorbitol, most recently I noticed the reaction from a peanut-butter sweetened with xylitol. I don’t chew gum often, but need to try eliminating all other sources from my diet and add back in the gum to see if I still have a reaction. I don’t know if it’s “dose-related” or if now that I’m sensitized to it is any dose would give this reaction?
I think that if I used it in toothpaste or mouthwash and spit it out, the amount that I would ingest would be negligible. I have heard that there are benefits of it helping oral bacteria and reducing cavities, but question how far the research has gone in determining whether it helps or hurts the gut microbiome. In the meantime, I need to be vigilant in looking at ingredient lists in all products and try by process of elimination to isolate what might be causing the excess mucus. It’s challenging because there are often multiple different potential culprits in the same product.
Any suggestion/comments, things that might have helped you in your journey would be appreciated. Thanks!
I have had a scary experience of having my throat restrict after gum with xylitol in it.
It took me on a trip to A&E yesterday, but I hadn’t put the two together until today. I had no gum all day, then after thinking to myself how much better I felt, I popped a piece of gum in my mouth and within minutes my throat started to restrict again.
Can’t guarantee that’s the cause without doing double blind experiments, but I’m feeling pretty confident it doesn’t agree with me.
I’ve consumed Xylitol in my coffee every day for probably 7 years – 2-3 teaspoons/day with no side effects. I’ve never found a Stevia product that is not overpowering and honestly, I hate the aftertaste.
I’ve been eating large amounts of xylitol in my cereal and drinks everyday for probably 10 years now. I can consume mega doses apparently without issue given what I’ve read here as well with no negative effects. I did however experience some cramping the first few times I used it, but never again.
Given I have a raging sweet tooth, xylitol is the only sugar substitute that actually tastes like sugar.
Well, just wanted to give my experience given I’ve been on a mega dose for 10 years without ill effect that I’m aware of.
I enjoyed your information on xylitol. I recently realized that there was a connection between my son’s tooth brushing and some of his seizures. He was diagnosed with epilepsy about a year ago, and is medication resistant. We have definitely noticed that sugary drinks and foods and white pasta often induce seizures and are working on improving his diet. We have used Tom’s of Maine toothpaste for years, and it just struck me one morning when my son had a seizure right after he brushed his teeth that it wasn’t the first time that had happened. Sure enough, when I looked at our seizure log, 15 out of the last 32 seizures were around tooth-brushing time. It still blows my mind. It’s hard to find a connection between xylitol and seizures online, but I have heard from others in an epilepsy group that I am in that it bothers them as well. I bought some Dr. Bronner’s toothpaste for him to use (sweetened with stevia only).
Here’s the point of my post and a question: Do you think there may be any long-lasting effects of the xylitol? My son is 11 and seems to be a responsible tooth-brusher — I don’t think he was swallowing large amounts — but do you think there’s a possibility that there could be traces of xylitol in his body still? I wonder if there’s any kind of a way to detox? Thanks for your help.
Thanks for sharing this research.
I was wondering if you saw this answer on the Xylitol brand you linked for the remineralizing tooth powder. Any idea about the effects of hydrogenation in the process?
“What is the source for this, corn or birch? Where was this manufactured?
Answer: I emailed the company and this is what they said: The xylitol in our products is derived from the fibrous or woody parts of Non-Gmo corn stalks and cobs. There is no corn kernel in the xylitol, so those with allergies to corn have no reaction to it. It is also casein and gluten free. Because there is no grain in the product, there are absolutely no micro-toxins found in our xylitol (It is tested for such impurities in the manufacturing process and as a finished product). The corn-derived xylitol does not require hydrogenation, like xylitol from birch trees, and since it comes from a renewable source we’re able to keep it affordable for our customers. Our Xylitol is manufactured in China. We are aware of the concerns that people have with products being made in China, so we do take extra precautions. We package all of our products here in the U.S. so we are able to inspect them before packaging. The FDA also inspects and approves. We also send a couple of our representatives to China around 6 times a year to check on the facilities. I can assure you that all of our products are safe to use. It is the pharmaceutical grade and is at least 99.8% pure. see less
By o2binhvn on November 26, 2013”
Xylitol seems to have a negative effect on my blood sugar, which I’ve been controlling with the Ketogenic diet. Just an FYI and I may be a rare case that this is so.
Very balanced article on Xylitol. I’d love to see this updated if there are newer studies.
Hi , I am currently taking a step back with sugar as I have had a few blood sugar problems recently. I bought a packet protein ball mix thinking it was sugar free and then I realised once I made them that they were super sweet. It has thaumatin in it. Or what they called fruit protein. Can you tell me anything about this sweetener? I’ve reasearched and can’t find a lot on it. I just don’t want to exacerbate my problems by eating something I don’t know anything about! Thank you.
I’ve been using Xylitol (from Birch tree bark) as a sugar substitute since four years. Because of parasite & candida problems I can’t tolerate any sugar whatsoever. I’ve gotten sick every time after eating sugar the last fifteen years without exception, and it lasted for weeks sometimes.
I’ve tried, but haven’t been able to totally ignore my sweet tooth, so this is the best I can do. I still have some health issues but not nearly as bad as four years ago, and Xylitol doesn’t seem to change much of anything (for better or worse) but I never get the terrible after effect or illnesses as I do from eating sugar. I would just catch whatever is/was going around, and sometimes there are things going around you are not even aware of. Last time was eating a molten chocolate cake in Nice France after riding a bus which happened to have some nasty respiratory track infection bacteria blowing out of their air conditioning and Voilà! Sick as a dog on holiday. Just when I thought I was strong and healthy.
I make a dessert a few times a year with it, but mostly use it for tea etc. I don’t eat Xylitol all the time. If I totally steer clear of sugar, I stay well enough.
Bottom line: Sugar feeds Candida and parasites. Sugar lowers the immune system. For people who have these types of problems as I have plus a sweet tooth, I think Xylitol is our only solution besides Stevia which I don’t particularly care for.
Might birch essential oil be a better choice? Just a thought… looking into it now… 🙂
I normally trust much of what you say… but Xylitol is NOT safe…. No WONDER kids love it it Jack N Jill toothpaste (the first ingredient is xyliton) it’s like brushing your teeth with sugar taste… Aside from that:
When foods that are eaten are normally digested, nutrients, like vitamins and minerals, are absorbed into the bloodstream in the small intestine. However, when chemical compounds like xylitol are consumed, the body cannot utilize them so they travel through your GI tract relative unscathed.
The fact that xylitol is “hydrogenated” should raise some concerns because hydrogenated foods are known to cause: (6) Alzheimer’s Disease Behavioral irritability and aggression Cancer Diabetes
Obesity Liver dysfunction Major depressive disorder
ALSO, nickel is used in that hdrogenation process and IT: is a known toxin has been linked to: Asthma attacks Cancer Dermatitis (skin allergies) Hand eczema (skin rash) Indigestion Kidney problems Lung disorders
It’s discouraging that we, as consumers, MUST distrust vendors since they DON”T always list actual ingredients… especially those used to PROCESS the ingredients… We’re ALL at risk & we MUST either MAKE the products ourselves or find companies that are honest…. TRULY honest. (Haven’t found many of those)
FINAL note: Caution in using ANYTHING if not in its ORIGINAL form.. Once man messes with it, who KNOWS what has been done to it… and they’re not telling … because THEIR primary interest is SELLING the product & MAKING PROFITS., NOT in giving healthy products to consumers.
Hi Rick- I removed the link you included because I refuse to link to that website, as I strongly disagree with the ethics and methods of its founder and have had some issues with him in the past. That being said, I certainly didn’t say Xylitol was safe in this post. There is some research supporting its use in dental products only, and as I said, I won’t use it internally and wouldn’t recommend that others do either. At the same time, just because something is in its natural form doesn’t mean it is safe, just as not everything that has undergone any form of processing is harmful.