Why I Stopped Sweetening My Chocolate with Erythritol

And what the science actually says about this popular sugar substitute

Published by Matthew Caruana | Keto Chocolate Maker & Low Carb Sweetener Specialist

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For several years, erythritol was my go to sweetener for my keto chocolate. It ticked every box: no blood sugar spike, zero calories, heat stable, and it tasted very close to sugar - or close enough at least.

Then in April 2026 a customer alerted me to some new research.

I'm not here to tell anyone what to eat or how to live, and I try very hard not to be prescriptive with any information that I present, but instead to share the facts as I am aware of them so everyone can make the best informed decisions for themselves.

I can tell you why I personally stepped away from it though and explain a bit of the science that made me take that decision.

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What Is Erythritol?

Erythritol belongs to a family of chemicals called sugar alcohols, or polyols, which aren’t sugars or alcohols in the traditional sense, but a chemical class that sits somewhere between the two. It occurs naturally in small amounts in fruits like grapes, melons, and pears, and in fermented products like soy sauce and wine. Your body even produces erythritol in several processes, most notably as a normal part of carbohydrate digestion, in something called the pentose phosphate pathway.

Commercially available erythritol is manufactured, usually from maize in a controlled fermentation. Originally the erythritol I was using all came from China (where most of the worlds erythritol production happens), but I was later able to source it from France. Maize starch is converted into glucose via hydrolysis, then fermented by specific yeasts until erythritol crystals form, which are then filtered, dried, and milled into the white granules we are familiar with.

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Why Erythritol Became So Popular

The appeal is easy to understand. In a world increasingly wary of sugar's metabolic effects, erythritol offered something genuinely unusual: sweetness without consequence, or so it seemed.

Its glycaemic index is effectively zero. It doesn't raise blood glucose or trigger an insulin response in the way sugar does. It contains virtually no usable calories. It's “tooth friendly”, since cavity causing bacteria can't ferment it. And unlike many other sugar alcohols (maltitol, sorbitol, xylitol), it's well tolerated digestively by most people, because around 90% of it is absorbed in the small intestine and excreted unchanged in urine, rather than fermenting in the gut.

For the keto and low carb community in particular, erythritol became a staple. It provided the bulk and mouthfeel that intensely sweet options like stevia and monk fruit couldn't, while still keeping net carbs at zero. Blended with stevia, it became the backbone of many home bakers attempts to lower their sugar consumption. By the time I came to write Everyone Deserves Dessert, the stevia and erythritol blend “Truvia” was available in even the smallest UK supermarket, so I decided to base my dessert recipes around it.

Since then, scores of sugar free treats and baking mixes have sprung up using erythritol or erythritol blends as their sweetener.

In chocolate specifically, it behaves really well. The only real issue is a noticeable cooling sensation on the palate, caused by the endothermic reaction that actually takes the heat from your mouth everywhere it dissolves. Many people will refer to this as a menthol “flavour” but the reality is that it is creating physical cold, rather than imparting any sort of minty flavour. There are several ways to reduce this, like using erythritol combined with other sweeteners, or simply to make your product less sweet.

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How The Science Changed

For most of its commercial existence erythritol was seen as a clean and safe ingredient. Then, in 2023, a paper was published in Nature Magazine that started a ball rolling.

The research came from the Cleveland Clinic. They began by casting a wide net, testing blood samples from over 1,000 patients at increased cardiac risk and looking for compounds whose levels correlated with future cardiovascular events, specifically heart attacks, strokes, and death, tracked over three years. Erythritol came up as one of the flagged compounds.

The team then sought to confirm the finding in two independent cohorts in the US and Europe, totalling nearly 3,000 additional participants. The association held - higher circulating levels of erythritol were linked to increased risk of major adverse cardiovascular events.

Crucially, the participants in these trials were not consuming erythritol. They were patients already being treated for cardiovascular issues, who were eating a standard high carb western diet. The studies didn’t show that eating erythritol lead to a higher risk of cardiovascular complications, but rather this endogenous erythritol (produced naturally as a normal part of carbohydrate digestion, in the pentose phosphate pathway) was a marker that could be used to predict future negative health outcomes. The elevated levels of blood erythritol were the result of higher consumption of simple carbohydrates, but it suggested that exogenous (dietary) raised blood erythritol should also be studied to determine if the increased erythritol levels were just a marker, or if they might actually be causing some of those negative outcomes.

That research was followed by a clinical study which found that ingestion of 30g of erythritol causes a thousand fold rise in plasma erythritol levels, and that those increased levels were associated with significantly increased platelet aggregation, a precursor to blood clot formation, that would in turn, increase the clotting rate and intensity. This study also administered 30g of glucose to participants but found no resultant effect on platelet aggregation or reactivity.

In a study from the University of Colorado Boulder, researchers exposed blood brain barrier cells to levels of erythritol typically found after drinking an erythritol sweetened soft drink and saw a chain reaction of cell damage that could make the brain more vulnerable to blood clots, a leading cause of stroke.

The same Cleveland Clinic research group extended their findings to xylitol. High levels of circulating xylitol were also associated with an elevated risk of cardiovascular events in an analysis of more than 3,000 patients in the US and Europe. A third of patients with the highest amount of xylitol in their plasma were more likely to experience a cardiovascular event. The study concluded that xylitol increased platelet reactivity to the same degree as erythritol.

The emerging concern is real but not yet definitive. The association between erythritol and cardiovascular risk is now supported by multiple independent lines of evidence. However, these are not randomised controlled trials that actually prove causation, and the populations studied were often already at elevated cardiac risk. Any possible and as yet unproven risks would also need to be weighed against the very real health risks of excess glucose consumption.

If you're a healthy person using these sweeteners occasionally, the evidence doesn't demand immediate alarm but the science has meaningfully shifted from the previous consensus that polyols are entirely benign, and further long term safety studies are clearly warranted.

Current evidence is that the platelet hyperactivity effects only last as long as erythritol is present in the blood. Typically, most erythritol will have been removed from the blood stream within 48 hours with any remaining being removed after a total of 36 hours. As yet, no studies have been conducted on the long term effects of chronic erythritol consumption.

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Why I Stopped Using It in My Chocolate

I have always run my company within strict moral boundaries – the belief that it shouldn’t cause harm. I have made my production, packaging and even how I commute to work as environmentally friendly as possible. I only use cocoa that is traceable and verifiably not coming from any forms of child labour or slave labour.

In April 2026 a customer sent me a link to some of the research I’ve touched upon. I was very busy at the time and honestly I didn’t expect it to be anything of substance, but a few days later I looked into it, and it quickly became apparent that my customer had been right to be concerned.

I realised that my chocolate had the possibility to be negatively effecting my customers health, and within my moral boundaries that possibility was unacceptable. I finished up what I was making and put my last erythritol containing treats on my website, followed by an email newsletter explaining my concerns, so that my customers were as aware of my doubts as my morality dictated.

I knew this was quite possibly the end of my business, and it still might be, but ethically there was no question about how I should proceed.

 

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What This Means And Doesn't Mean

None of this is a verdict on erythritol for everyone. The research is ongoing, the mechanisms are not fully established, and individual circumstances vary enormously. Plenty of people consume it regularly without any apparent issue. For those managing diabetes or following a strict low carb diet where erythritol is a useful tool, the calculation may look entirely different to mine.

If you have any concerns about the safety of erythritol, or any other ingredient, I encourage you to research it for yourself. Trawling through research isn’t everyone’s cup of tea though, so you are likely to get any information through someone else’s interpretation of that research, just like this is my interpretation. Cast your net wide and read as many opinions as you can, and always consider who the writer is, what level of understanding they might have, and if there is likely to be any bias, whether conscious or otherwise.

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This post reflects personal experience and publicly available research. It is not medical or nutritional advice. If you have specific health concerns about any ingredient in your diet, speak to a qualified healthcare professional.