• Diabetes
• Weight Management

Sorbitol Explained: The Sweet Secrets of Healthier Sugar Alternatives

Medically reviewed and edited by Cara Konzel, MS, RN, ACNP-BC

Are you searching for a healthier sugar substitute or relief from constipation? Sorbitol may be the solution to both of these problems.

Whether you’re one of approximately 4 million Americans who struggle with constipation, one of nearly 40 million who have diabetes, or you’re simply trying to cut back on sugar to get healthier, this article has all the information you need.

Keep reading to learn about sorbitol, what it can be used for, and how you should use it.

What is Sorbitol?

Sorbitol is a type of sugar alcohol that serves as a low-calorie sweetener and an alternative to regular sugar.

It's about 60% as sweet as table sugar and is commonly used in sugar-free or diabetic-friendly products. Other sugar alcohols like erythritol, maltitol, and xylitol have similar uses.

Sugar alcohols, like sorbitol, are naturally present in small amounts in fruits such as berries, prunes, plums, dates, apples, and nectarines, and contribute to the sweetness of these fruits.

Is Sorbitol Good or Bad for You?

The U.S. Food and Drug Administration (FDA) has approved sugar alcohols, including sorbitol, as sugar substitutes.

Due to its affordability, sorbitol is widely used in the U.S. for personal and medical applications — we’ll describe these in more detail below.

What are the Benefits of Sorbitol?

Aside from being an economical choice for those looking for a sugar alternative, there are several other reasons to incorporate sorbitol into your diet. We’ve listed the top benefits below:

Promotes oral health

Sorbitol – along with other sugar alcohols – is better for your teeth than regular sugar.

The FDA highlights that dietary sugars are known for their cavity-promoting effects. When bacteria in the mouth encounter sugars and carbohydrates, they metabolize it and produce acid as a byproduct.

The acidic environment makes teeth softer and more vulnerable to plaque formation. Over time, this plaque accumulation leads to tooth decay.

However, bacteria can’t metabolize sugar alcohols like sorbitol in the same way. They produce less acid and at a slower rate, thereby significantly reducing the risk of tooth decay.

Lower caloric content

Sorbitol is a sugar alcohol that the human body metabolizes slowly.

Because it’s not fully processed in the small intestine, the unmetabolized portion moves to the large intestine for further breakdown.

This slowed-down metabolic process means the body absorbs fewer calories, as nutrients broken down later in the digestive system are less efficiently absorbed.

Additionally, this characteristic of sorbitol helps in maintaining stable blood sugar levels, avoiding the spikes typically caused when regular table sugar is metabolized.

Alleviates constipation

Sorbitol acts as an osmotic laxative, drawing water into the large intestine to soften the stool and stimulate bowel movements.

By increasing the water content in the bowel, sorbitol enhances peristalsis — muscular contractions that move contents through the digestive tract — aiding in faster stool transit and relieving constipation.

However, excessive use can cause gastrointestinal discomfort. Research shows that more than 20g of sorbitol per day can result in diarrhea.

Sorbitol should only be used to treat occasional constipation. Prolonged use can make your body dependent on sorbitol for regular bowel movements.

As a laxative, sorbitol is available as a rectal enema or liquid solution.

What is Sorbitol Used for?

In addition to the laxative effect mentioned above, sorbitol boasts a wide array of applications in both medical and everyday settings. Medical uses of sorbitol

Sorbitol is widely used in various medical applications, ranging from treatments to preparations:

Medicinal sweetener

With around half of the sweetness of regular sugar, sorbitol is frequently used as a pharmaceutical sweetener to enhance the taste of liquid or syrup medications. This makes medications more palatable for kids who have difficulty taking them.

Colonoscopy preparation

In enema form, sorbitol is used for bowel preparation before colonoscopy procedures, ensuring clear bowels to avoid complications.

Osmotic diuretic

Sorbitol functions as a diuretic by raising osmotic pressure in the kidneys, promoting the release of water through urination.

Excipient in pharmaceuticals

Sorbitol also acts as an excipient — a vehicle to help carry active ingredients in medications. This makes it a crucial ingredient in the formulation of many capsules or chewable tablets.

It also acts as a stabilizer in various pharmaceutical products like vitamins and antacids, enhancing the stability and usability of these medicines.

Regular uses

• Low-calorie sweetener: Research indicates that sugar alcohols like sorbitol are healthier and more effective alternatives to table sugar. With its lower calorie content and negligible impact on blood glucose levels, sorbitol is an ideal choice for those aiming for weight loss and a safe sugar substitute for diabetic patients seeking to satisfy their sweet cravings.

• Humectant: Sorbitol is a great humectant — a compound that helps retain water or moisture. It’s used in canned foods to preserve moisture, in makeup storage to prevent drying out, and in baked goods to keep them from becoming stale.

• Stabilizer and thickener: Medicinal formulations often contain sorbitol to stabilize the main drug. It’s commonly used in antacids and vitamins.

• Texture agent: Sorbitol enhances the bulk and texture of various substances, contributing to their desired consistency. Additionally, it effectively prevents the crystallization of syrups, ensuring smoothness and uniformity, especially around the rim of the bottle.

• Non-cariogenic sweetener: Sugar alcohols like sorbitol do not contribute to tooth decay and have been stated to promote good dental health by the FDA. However, chewing gum and candies with sorbitol should be consumed in moderation to avoid side effects.

What are the Side Effects of Sorbitol?

Sorbitol has passed rigorous food safety trials and is generally recognized as safe for consumption. However, it's important to be aware of potential side effects:

• Gastrointestinal discomfort: New users of sorbitol may experience abdominal pain and discomfort

• Bloating and flatulence: Sorbitol can cause bloating and gas

• Diarrhea: A common side effect, especially with higher consumption

If you experience symptoms like vomiting, dizziness, or rectal bleeding, contact your healthcare provider immediately.

Dosage Instructions: How Do I Take Sorbitol?

As a medication, sorbitol can be taken either as an oral solution or through a rectal enema. It's crucial to adhere strictly to your doctor's guidance or the instructions on the label when using sorbitol.

Always follow the recommended dosages and consult a healthcare provider for personalized advice — especially if you have a chronic condition, as use may differ.

Adult dosage:

Oral solution

Mix: Combine 70% sorbitol with 30% water or flavored drink.

Dosage: Consume no more than 1–5 oz of the mixture.

Rectal enema

Mix: Prepare a solution of 25–30% sorbitol with 75–70% liquid.

Dosage: Use about 4 oz for the enema.

Note: Pre-mixed solutions are available at drug stores.

Sorbitol has severe side effects on children – such as gastrointestinal issues, including bloating, gas, and diarrhea. While dosage instructions for children are typically available on the label or packaging, the use of sorbitol is not recommended for children.

Sorbitol Drug Interactions

Drug interactions occur when one medication affects how another is processed by the body.

Before using sorbitol, it’s essential to disclose any medication you’re currently taking to your doctor or pharmacist.

Below are some key interactions to consider:

• Sodium polystyrene sulfonate: This medication treats high potassium levels and is sold under brand names like Kalexate®, Kayexalate®, and Kionex®. When combined with sorbitol, it can lead to intestinal necrosis — a severe and potentially fatal condition that causes death of the intestines.

• Lamivudine: Lamivudine is an antiretroviral (ARV) drug for HIV and Hepatitis B treatment. In some patients, sorbitol may reduce the ARV levels in the blood, impacting its effectiveness.

Who Should Not Be Taking Sorbitol?

While sorbitol is generally safe, its misuse or excessive consumption can lead to adverse effects. Always remember, with sorbitol, moderation is key. Special considerations should be taken for the following groups::

Children: Sorbitol is not recommended for relieving constipation in children who exhibit symptoms like nausea or abdominal discomfort.

These symptoms could indicate an underlying condition that requires medical attention.

Pregnant women: Sorbitol is considered safe during pregnancy, but its side effects – including bloating, gas, and abdominal cramps – can make pregnancy less comfortable.

Pregnant women should only use sorbitol in small, controlled amounts.

Excessive intake can cause diarrhea, leading to dehydration and reduced nutrient absorption, which are concerns during pregnancy.

Sorbitol Alternatives

If you’re looking for alternatives to sorbitol, you can explore sugar alcohols like xylitol, erythritol, and maltitol. These offer similar levels of sweetness with varied health benefits.

To lower your risk of constipation, consider lifestyle modifications like boosting your physical activity, establishing a regular bathroom schedule, and maintaining a balanced diet.

Some other natural remedies for constipation include:

• Fruits and nuts

• Flaxseed and chia seeds

• Whole grains, vegetables, and legumes

Where Can I Learn More About Sorbitol?

Seeking relief from constipation or a sugar substitute suitable for diabetics? Turn to LifeMD.

An expert healthcare team can offer personalized guidance on maintaining regularity, effectively managing your diabetes, and choosing the right sugar substitute for weight control — all conveniently accessible from the comfort of your home.

Book your appointment today to get started.

Cara Konzel, MS, RN, ACNP-BC

Cara earned her BA in Biology, BS in Nursing, and MS in Nursing — all from the University of Rochester. Cara's approach to medicine and patient care is grounded in years of experience and extensive knowledge. She combines compassion and personalized attention to ensure her patients feel valued, understood, and empowered to participate in their own health journey. Cara enjoys spending time with her three children, caring for her aging parents, and gardening.

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