This natural sugar substitute causes digestive problems

Dr. Frank Shallenberger, MD

April 25, 2022


Are you trying to stay away from sugar? I hope so. Sugar causes all sorts of health problems and contributes to many others.

However, what you use as an alternative is important. One alternative many use can cause serious digestive issues. Just ask Genny….

Genny, one of my patients, was using this sugar substitute and ended up seeing doctors for one-and-a-half years before anyone discovered her problem.

That’s when Genny came to see me. Her problem was diarrhea and gas. Diarrhea to the tune of four to five times per day. She had already done all the lab work and everything was normal. So I did the thing that most doctors don’t have enough time to do. I talked with her for an hour. And before the hour was up, we both knew the problem was sugar alcohols.

Sugar alcohols, also known as polyols, are not alcohol. They also are not sugar. Their name comes from the fact that part of their molecular structure is similar to sugar and the other part is similar to alcohol.

Sugar alcohols are found naturally in foods such as vegetables and fruits. And like sugar, they are very sweet. But they have only about half the calories of sugar. And unlike sugar, they don’t increase blood sugar levels and don’t require the hormone insulin to metabolize them. That’s the good news.

Here’s the bad news. The reason sugar alcohols don’t raise blood sugar is because your body only partially digests and absorbs them. This means that they can accumulate in the large intestine and cause bloating, gas, and diarrhea. Since different people have different digestive capacities, some people will get these symptoms with only a small serving of sugar alcohols. Others can get away with larger doses.

So if you are having any of these symptoms and have been eating sugar-free candies, energy bars, chewing gums, or diabetic treats, your problem might be due to sugar alcohols. These sweeteners also are common in throat lozenges.

You can identify sugar alcohols on the ingredients label either as “total sugar alcohols” or by their individual names: erythritol, xylitol, sorbitol, isomalt, mannitol, lactitol, maltitol, and hydrogenated starch hydrolysates (HSH). Note that one easy way to identify sugar alcohols is from their names. Most sugar alcohols end in “-ol.”

One last thing. One of these sugar alcohols does not usually cause symptoms. That’s erithritol. The reason is because unlike the others, your body can completely absorb erithritol. The reason that it’s still low in calories and doesn’t cause a raise in blood sugar is because the cells can’t use it. So your body eliminates it intact in your urine. So if you want the benefits of a sugar substitute without the risk of symptoms, your safest bet is erithritol.

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