Research

Hormonal

High circulating levels of the artificial sweetener erythritol are associated with a significantly increased risk of major adverse cardiovascular events (MACE), including heart attack and stroke, and directly enhance platelet reactivity and thrombosis potential.

If you consume erythritol (a common artificial sweetener in 'keto' products, sugar-free drinks, and baked goods), be aware that it can accumulate in your blood and make your platelets more likely to form clots. This risk is particularly relevant if you have existing heart disease, diabetes, or high blood pressure. While occasional use may not pose a significant risk for healthy individuals, those at higher cardiovascular risk should consider limiting erythritol intake and consulting their doctor, especially given that levels can remain elevated for days after consumption.

GoodSupportsHIGH confidence
In both validation cohorts, plasma levels of erythritol were higher among individuals with prevalent CVD... higher levels of erythritol were also observed among those who experienced an incident MACE over the ensuing 3 years of follow-up... erythritol enhanced platelet reactivity in vitro and thrombosis formation in vivo.
Marco Witkowski et al. · Nature Medicine · 2023

Why this rating

Strong observational data across multiple large cohorts (n>4,000) combined with consistent in vitro and in vivo mechanistic evidence, though the intervention study was small (n=8).

Source

The artificial sweetener erythritol and cardiovascular event risk

Marco Witkowski et al. · Nature Medicine · 2023

DOI 10.1038/s41591-023-02223-9

cohort · n=4139Cited 204×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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