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Is Xylitol Healthy
  • Health

Xylitol: Is It Healthy or Safe?

Katie WellsFeb 22, 2015Updated: Dec 14, 2021
Dr Scott Sorries Medical Advisor Wellness Mama
Medically reviewed by Dr. Scott Soerries, MD
Reading Time: 4 min

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Wellness Mama » Blog » Health » Xylitol: Is It Healthy or Safe?
Table of Contents[Hide][Show]
  • What Is Xylitol?
  • Xylitol as a Sweetener?
  • Xylitol for Dental Health?+−
    • Important: Xylitol and Dogs
    • My Take on Xylitol

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)

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:

  • Remineralizing toothpaste 
  • Simple whitening toothpaste

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!

Sources
  • Bahador A, Lesan S, Kashi N. Effect of xylitol on cariogenic and beneficial oral streptococci: a randomized, double-blind crossover trial. Iran J Microbiol. 2012 Jun;4(2):75-81.
  • VCA Animal Hospitals: Xylitol Safety in Dogs
  • Hujoel PP, Makinen KK, Bennett CA, et al. The optimum time to initiate habitual xylitol gum-chewing for obtaining long-term caries prevention. J Dent Res. 1999;78(3):797-803.
  • Milgrom P, Ly KA, Roberts MC, et al. Mutans streptococci dose response to xylitol chewing gum. J Dent Res. 2006 Feb;85(2):177-81.
  • Mattila PT, Svanberg MJ, Pokka P, et al. Dietary xylitol protects against weakening of bone biomechanical properties in ovariectomized rats . J Nutr. 1998 Oct;128(10):1811-4.
  • Mattila PT, Svanberg MJ, Knuuttila ML. Increased bone volume and bone mineral content in xylitol-fed aged rats. Gerontology. 2001 Nov-Dec;47(6):300-5.
  • Uhari M, Kontiokari T, Niemela M. A novel use of xylitol sugar in preventing acute otitis media. Pediatrics. 1998;102:879–84.
  • Sato H, Ide Y, Nasu M, et al. The effects of oral xylitol administration on bone density in rat femur. Odontology. 2011 Jan;99(1):28-33.
Category: HealthReviewer: Dr. Scott Soerries, MD

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About Katie Wells

Katie Wells, CTNC, MCHC, Founder of Wellness Mama and Co-founder of Wellnesse, has a background in research, journalism, and nutrition. As a wife and mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.

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Reader Interactions

Discussion (45 Comments)

  1. Jean

    April 4, 2016 at 12:35 PM

    I accidentally had some xylitol and let’s just say I was sick as a dog and don’t go into specifics! Lately, I have been considering using it in toothpaste but it’s hard to want to do that after my experience.
    As for Stevia, I have had it growing and is very nice once you learn that is very strong and only takes a tad. I’ve also died it and used it in teas or as tincture, again very good if you don’t use too much. It has a bitter taste if you’ve used too much. My plants didn’t come back this year so I will plant more. The plant looks a lot like mint or catnip.

    Reply
  2. Tiffiny

    March 10, 2016 at 12:17 PM

    Has anyone noticed that xylitol smells like witch hazel? That alone made me not want to use it. I have a whole bag if it niw, may need to try out toothpaste or something instead. What is a good recipe for xylitol toothpaste?

    Reply
  3. Rachel

    January 21, 2016 at 9:57 AM

    I used xylitol on a 10 year old sinus infection that I had been suffering from horrifically, sneezing hundreds of times a day sometimes. I think it was caused by a root canal tooth but it persisted long after the tooth had been pulled. Doctors insisted it was allergies. Yea, uh huh, allergies to the bacteria in my own nose! Xylitol works painlessly to kill the bacteria and when you spray it up your nose, and it gives instant relief.

    I’ve been sinus trouble free for about a year now. I also have morgellons disease and that could have been up my nose too. That’s how I found out about xylitol, from a website that gave a recipe to kill a morgellons sinus infection. So xylitol is a miracle medicine for those that have sinus trouble.

    Reply
  4. Maggie

    December 5, 2015 at 10:18 PM

    Thank you Katie! I’ve been searching for a toothpaste for my 12 mo old. We bought Nuk’s infant tooth and gum cleanser. I wondered about some of the ingredients, including xylitol. Your article has put my mind at ease about that ingredient. I’m still unsure about the others (listed below – any red flags?) What do you use for your babies’ teenie teeth? Thanks! !

    (Ingredients: glycerin, xylitol, sorbitol, propylene glycol, pectin, xanthan gum, silica, “flavor”, sorbic acid, calcium lactate)

    Reply
  5. Trudy

    August 5, 2015 at 3:13 AM

    Hi Katie – I just wondered if you had read this article and what your thoughts and comments are? https://www.thehealthyhomeeconomist.com/xylitol-not-as-sweet-as-its-cracked-up-to-be/ – I was particularly concerned re the hydrogenation process used to make Xylitol, bearing in mind the huge blunder and disaster with hydrogenated oils!!! Also that,the process used for the hydrogenation involves nickel, a heavy metal! Finally it is stating it disrupts the gut bacteria and knowing how passionate you are about healthy gut bacteria I wondered how you feel about this? Whilst I realise you are not an advocate, to date, on ingesting this in food,until there is more information on the safety of it, obviously a certain amount does get in to your body via the toothpaste and mouthwashes you use and I wondered how you feel about that too? Whilst I realise we are different to animals and we can safely consume things they may not be able too, as in the case of dogs and chocolate, but it does also appear that,in tests, quite a small amount of this actually killed the rats it was being tested on!!! I do find this rather alarming and concerning even so!! Love your site Katie and am a frequent visitor too it- thank you – I don’t know how you fit it all in with five children, a home to run and making all your own products!!! I salute you!??

    Reply
  6. Lourdes

    March 2, 2015 at 10:42 PM

    Hi everybody. I follow a strict sugar free diet and my naturopath told me to only use stevia, 100% pure, I use sweet leaf and xylitol not coming from corn, she is a very anti corn-gmo naturopath and recommended me Xyla as it is 100% birch tree.

    Reply
  7. Tanya

    March 2, 2015 at 2:54 PM

    Xytol put me in the hospital and I will never use it again. The headache it caused mimicked a stroke and began a catastrophic system failure in my body. I still suffer from frequent debilitating migraines.

    Reply
  8. Pauline

    March 2, 2015 at 9:22 AM

    I appreciate your balanced approach. However as someone who lives with a serious IBD, I can say from experience that Xylitol is a definite no-no. After ingesting just a small amount, even from chewing gum, I will have serious pain and cramping that will last for days if not weeks. Every person who lives with IBD has different responses to what they ingest so another person may not have the same experience, but in general we all need to be very aware of what we’re ingesting and how our body reacts. IBDs are one of the fastest growing health issues.

    Reply
  9. Christine

    March 1, 2015 at 6:10 PM

    Hi, I created a product that I used xylitol in. I was very careful where I bought my xylitol from and made sure it is not from corn. Xylitol from corn (GMO) is usually from China. There is a Company out of Aurora, CO called Xylitol USA gets their Xylitol from the Birch Tree. They are a very green company and use every part of the tree. The company is out of Canada but they have the US side. You can also order their products on line. I sold my product to a company in Boulder and they did remove the Xylitol (because of the way people perceive it) and changed to coconut sugar (they are also a great company that is very green and care about ingredients they use, everything is organic and certified).
    I personally don’t think Xylitol is bad for humans, you use it 1 for 1 to sugar without a strange after taste. Natural Grocery stores carry xylitol and I found they are usually from China (check your source) or be safe and go with Xylitol USA or one from the Birch tree (non-GMO). Get on their website, they are always having specials. Hope that helped!

    Reply
  10. Sally smith

    March 1, 2015 at 10:21 AM

    What is your take on a product that uses xylitol as a sinus care spray?

    Reply
    • Katie - Wellness Mama

      March 2, 2015 at 1:03 AM

      There is some evidence that it can help with that but I have not tried it and would personally try other remedies first…

      Reply
      • Alejandra

        June 3, 2019 at 2:23 PM

        I have an almond spread that has Xylitol. Should I be concerned and discontinue use?

        Reply
    • Tara

      December 5, 2015 at 11:59 PM

      A naturopath once told me to use it in the Neti pot and rinse to fight sinus infections. It works! 1 tablespoon per 2 cups warm water.

      Reply
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