• Weight Management
• Diabetes

Exploring the Benefits and Dangers of Xylitol

Medically reviewed and edited by Holly Lunsford, APRN, FNP

You might have noticed xylitol listed as an ingredient on your go-to sugar-free chewing gum — but have you ever wondered what it is?

In this article, we’ll explain all you need to know about xylitol, including its dental benefits, health benefits, and potential risks and side effects.

What is Xylitol?

Xylitol is a sweetener that looks and tastes like regular table sugar.

This sugar alcohol – also known as a polyol – has the same level of sweetness as sugar, but only 40% of its calories.

Unlike many other sugar substitutes, Xylitol naturally exists in fruits and vegetables. However, most of the xylitol we use is made from birch or beechwood, which is why it’s also known as birch sugar.

Xylitol is used as an ingredient in many products and it’s also for sale as a tabletop sweetener from brands like Ideal®, PolySweet®, and Xylosweet®. It dissolves easily in water, making it great for sweetening drinks like tea, coffee, and sodas.

Is Xylitol Good or Bad for You?

The Food and Drug Administration (FDA) has classified xylitol as generally recognized as safe (GRAS) and approved its use as a food additive.

This means it can be safely added to foods for its sweetening effects – as long as it's used in appropriate quantities.

Additionally, the FDA recognizes xylitol, along with other sugar alcohols, as a non-cariogenic sweetener, meaning it doesn't contribute to tooth decay.

What are the Potential Benefits of Xylitol?

Xylitol offers a range of health benefits beyond its low calorie count. From dental health to gut wellness, here's a closer look at what xylitol can offer you:

• Prevents tooth decay: Xylitol helps in reducing tooth decay. Unlike sugar, it doesn't contribute to the growth of decay-causing bacteria in the mouth, and isn’t metabolized into acids that may damage tooth enamel.

• Prevents gum disease: Xylitol is effective in preventing gingivitis and other gum diseases by inhibiting the growth of harmful bacteria and reducing plaque formation.

• May help with weight management: While it's believed that xylitol can aid in weight loss by reducing overall calorie intake, this is a controversial point. A recent systematic review suggests that nonnutritive sweeteners like xylitol may not offer long-term benefits in weight management. It's important to note that systematic reviews are considered the gold standard in research for quality evidence.

• Supports gut and immune health: Xylitol acts as a prebiotic, fostering a healthy environment for beneficial gut bacteria to grow. This supports overall immune health.

• Relieves constipation: Due to its structure, xylitol can have a mild laxative effect, which may help relieve constipation.

• Alleviates symptoms of rhinosinusitis: When used in nasal irrigation solutions, xylitol can improve the symptoms of rhinosinusitis — an inflammatory condition affecting the nasal cavity.

• Prevents respiratory tract infections: Xylitol may help in preventing infections in the respiratory tract by inhibiting the growth of bacteria.

What are the Potential Risks or Dangers of Xylitol?

As we mentioned above, xylitol offers numerous health benefits. Although there are no well-documented drug interactions with xylitol, you should be aware of its potential risks and side effects.

Here’s what you should know to keep your entire family — including your pets — safe when using xylitol:

Xylitol can cause digestive issues

Unlike regular sugar, xylitol isn’t completely absorbed by the human body.

This partial absorption may lead to weight-loss benefits, as it causes fewer calories compared to regular sugar, but it can also lead to several unpleasant side effects:

• Flatulence: The fermentation of xylitol by gut bacteria produces gas, leading to increased flatulence.

• Diarrhea: Xylitol's ability to draw water into the colon can result in diarrhea.

• Abdominal pain or cramps: The gastrointestinal disturbance caused by xylitol can lead to abdominal pain or cramping.

• Watery stool: Due to its effect on water absorption in the colon, xylitol can cause watery stools.

• Bloating: The gas produced during fermentation, along with water absorption, may also cause bloating.

Xylitol: The hidden danger to dogs in your home

The FDA has issued a warning to dog owners who use xylitol.

This sugar substitute can be fatal to your furry friend, so contact your vet, local animal poison control center, or emergency clinic if you suspect your dog has consumed xylitol. Adverse effects can start within 20 minutes after your dog has ingested xylitol.

Xylitol causes the following problems in dogs:

Toxicity: One of the most significant risks associated with xylitol is its toxicity to dogs. Xylitol is found in many snacks and household products, increasing the risk of accidental ingestion by pets.

Hypoglycemia: Dogs’ bodies cannot differentiate between xylitol and actual sugar. When a dog ingests xylitol, its pancreas may mistake it for sugar and release insulin. This can lead to a dramatic drop in the dog's blood sugar levels (hypoglycemia), which is extremely dangerous.

Severe health implications: The hypoglycemic effect xylitol causes in dogs can be life-threatening. It may result in permanent brain damage – a condition known as neuroglycopenic brain injury.

Symptoms of xylitol poisoning in dogs include vomiting, loss of coordination, seizures, and in severe cases, it can be fatal. There’s also research to suggest that acute liver failure may occur in dogs after xylitol ingestion.

Dog owners who want to reap the health benefits of xylitol but still keep their pup safe should follow these steps:

• Store xylitol and products containing xylitol away from dogs.

• Avoid giving sugar-free treats to your dog.

• Inform everyone in your home about the risks of xylitol.

• Examine food labels carefully.

Although pets should avoid artificial sweeteners in general, accidents do happen. To ensure the safety of your pet, other sugar substitutes should be considered — more on this later.

What is Xylitol Used for?

Improving dental health

In the context of preventing dental caries (also known as dental cavities) and enhancing dental health, xylitol stands out as a beneficial choice.

While it's a common misunderstanding that sugar directly causes dental cavities, the real culprit is lactic acid — which is produced when oral bacteria metabolize sugars from our diet.

Xylitol doesn’t undergo this harmful process. Instead, the presence of this sugar substitute in the mouth hinders these bacteria's ability to produce lactic acid.

This makes products like xylitol sweetened gum particularly effective, not only in reducing acidic conditions that damage teeth, but also in boosting saliva production — which helps to neutralize the mouth's pH, further protecting against tooth decay.

One clinical trial showed that xylitol chewing gum and candies reduced the number of dental caries in children aged 10–12 by 35% to 60%.

Oral care products

Plaque formation in the mouth is a result of excessive bacterial growth and their adherence to teeth. These bacteria produce lactic acid, which can erode tooth enamel.

Additionally, they can cause inflammation in the gums, leading to gingivitis.

Xylitol is effective in disrupting the formation of plaque and inhibiting bacterial growth. This beneficial property is harnessed in oral care products, making xylitol an important ingredient in products that improve dental health.

Diabetic-friendly sweetener

Animal studies have suggested that xylitol might play a role in reducing blood glucose levels and decreasing insulin secretion, which could be beneficial for managing insulin levels and insulin resistance in individuals with diabetes.

Given its lower calorie content and reduced effect on blood sugar, xylitol is often seen as a suitable choice for individuals monitoring their glucose.

However, for those managing diabetes, where maintaining tight glycemic control is vital, consulting with a healthcare provider is crucial before introducing xylitol or making any substantial dietary modifications.

Advice from your doctor ensures that new dietary changes are safe for diabetes management.

Baking and use in food

Xylitol is a popular choice in baking for its sweetness, but it's not suitable for recipes where yeast is needed for the dough to rise.

Unlike regular sugar, xylitol cannot be metabolized by yeast to produce carbon dioxide, the gas crucial for creating the lift in the dough.

Yeast typically ferments sugar to generate this gas, forming air pockets within the dough that enable it to expand and rise.

However, this essential rising process isn’t possible when xylitol is used as a substitute for sugar. Some common uses for xylitol include:

• Sugar-free candies

• Chewing gum and mints

• Sugar-free desserts and cakes

• Peanut butter and chocolate

• Sauces and spreads

• Jams and jellies

Who Should Avoid Xylitol?

People who know that they’re allergic to xylitol should avoid it. If you have an allergy to other sugar alcohols, it's also recommended to proceed with caution.

Always consult with your healthcare provider before using xylitol if you have any allergies to sugar alcohols or suspect that you might be allergic to xylitol.

Xylitol in Pregnancy

The FDA deems xylitol safe for consumption during pregnancy and breastfeeding.

Notably, the use of xylitol by mothers — especially in chewing gum — can potentially lower the transfer of Streptococcus mutans from mothers to infants in the later stages of pregnancy and following childbirth. This bacteria is known to cause tooth decay.

Xylitol Alternatives

For those who own dogs or have a known allergy to xylitol, here are some alternative options:

__Natural sweeteners (nonnutritive) __

• Erythritol (0.7x)

• Mannitol (0.6x)

• Sorbitol (0.6x)

• Monk fruit extract (150–200x)

• Stevia (200–350x)

• Maltitol (0.9x)

• Thaumatin (2000–3000x)

Artificial sweeteners (nonnutritive)

• Saccharin (300x)

• Isomalt (0.5–0.6x)

• Aspartame (200x)

• Neotame (7000–13,000x)

• Advantame (37,000x)

• Sucralose (600–650x)

Note: Values in parentheses represent the relative sweetening power compared to table sugar.

Where Can I Learn More About Xylitol and Similar Sugar Substitutes?

Looking for an ideal sugar alternative? Visit LifeMD to learn more.

Whether you’re looking to manage your insulin levels or simply cut back on sugar, a team of experts can provide you with the guidance and support you need to make healthy lifestyle changes.

Book your appointment today to get started.

Holly Lunsford, APRN, FNP

Holly is an APRN with more than 10 years of experience. She earned her MS with a Family Nurse Practitioner concentration from the University of Memphis. Her extensive healthcare expertise spans across Emergency Medicine, Urgent Care, and Obesity Treatment.

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