Erythritol and Brain Health: Should We Be Worried?

A recently published in vitro study raised new concerns about erythritol, a sugar substitute commonly found in low-carb and "sugar-free" products. The research, conducted by scientists at the University of Colorado, suggests that erythritol may impair the function of brain endothelial cells—those that line the blood vessels in the brain.

While headlines quickly spread alarm, a closer look at the study and its context tells a more nuanced story.

What Did the Study Actually Show?

Researchers exposed human brain microvascular endothelial cells (hCMECs) in a lab setting to a dose of erythritol equivalent to what is typically found in a single artificially sweetened beverage (about 30 grams). After 24 hours, they observed:

• Increased oxidative stress

• Reduced nitric oxide (NO) production

• Increased endothelin-1 (a vasoconstrictor)

• Blunted release of tissue plasminogen activator (t-PA), a substance that helps prevent clot formation

These findings suggest endothelial dysfunction, a condition that—if sustained—can increase the risk of stroke and other vascular issues.

But This Was a Lab Study, Not a Human Trial

The most important thing to understand is that this was an in vitro experiment. The cells were studied in isolation, outside the body. There was no digestion, metabolism, circulation, or immune system involved—nor any of the complex biological processes that happen when a person eats or drinks.

In other words, these results do not prove that consuming erythritol in normal amounts causes harm in humans.

What Does the Human Evidence Say?

Some observational studies have found that higher blood levels of erythritol are associated with greater cardiovascular risk. However, association is not causation. Elevated erythritol levels could reflect underlying metabolic dysfunction rather than be the cause of it.

There are no clinical trials to date showing that moderate erythritol consumption causes disease in healthy individuals.

Could Daily Erythritol Use Be Harmful?

This depends on context. A single drink with erythritol is unlikely to pose a risk. For healthy people, moderate intake—especially as a sugar alternative in a balanced diet—appears safe.

For individuals with existing cardiovascular disease, diabetes, or a high risk of stroke, it may be wise to limit excessive daily intake until more research is available.

The Bottom Line

Erythritol is not inherently harmful. Like many ingredients, its effects depend on dose, frequency, and individual health status. The recent study offers an important clue about how erythritol may behave under specific lab conditions, but it does not justify public alarm or panic.

If you use erythritol occasionally or in small amounts as part of a healthy lifestyle, there is no evidence that you need to stop. As with everything in nutrition, context is key.

SOURCE: Journal of Applied Physiology