Blood Clotting Risk Doubles With Erythritol Consumption: Insights From Pilot Study

A recent pilot study found that drinking a beverage containing erythritol (an artificial sweetener used to boost the content of stevia and monk fruit and to sweeten low-carb ketogenic products) more than doubled the risk of blood clots in 10 healthy individuals.

Blood clots can break off from blood vessels and travel to the heart, triggering a heart attack, or the brain, causing a stroke. Previous research has linked erythritol to an increased risk of stroke, heart attack, and death.

Dr. Stanley Hazen, lead author of the study and director of the Cardiovascular Diagnostic and Prevention Center at the Cleveland Clinic Lerner Research Institute, noted that “remarkably, in all subjects, all measures of platelet (blood clotting) response were increased after erythritol ingestion.”

Taxing sugary drinks could prevent 2 million cases of diabetes and cardiovascular disease, a study suggests. Drinking a drink with the same amount of glucose, or sugar, did not affect platelet activity in another group of 10 people, according to Hazen, who also holds the Jan Bleeksma Chair in Vascular Cell Biology and Atherosclerosis at the Cleveland Clinic.

“This is the first direct comparison of the effects of glucose ingestion versus erythritol on multiple distinct measures of platelet function,” Hazen said. “Glucose doesn’t affect clotting, but erythritol does.”

Although small, the study was described as “very intriguing and interesting” by Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.

“I’m not saying we should stop using these sugar alcohols immediately, but this line of research certainly raises the question: Are they safe or not?” said Freeman, who was not involved in the research.

In response to the study, the Calorie Control Council, an industry association, told CNN that 30 years of scientific studies have shown erythritol to be a “safe and effective” option for reducing sugar and calories.

“Consumers should interpret the results of this pilot study with extreme caution. The limited number of participants, a total of 10, received an excessive amount of erythritol, nearly four times the maximum amount approved in any beverage in the United States,” board chair Carla Saunders said in an email.

However, the amount of erythritol used in each beverage in the study (30 grams) was equivalent to that found in typical soft drinks, ice cream, or sugar-free muffins, of which people often consume more than one, Hazen pointed out.

“This research raises some concerns about whether a standard serving of an erythritol-sweetened food or beverage could acutely stimulate a direct clot-forming effect,” noted study co-author Dr. Wai Hong Wilson Tang, director of heart failure and transplant research at the Cleveland Clinic.