Are xylitol, erythritol, and other sugar alcohols safe to consume when you have Hashimoto’s hypothyroidism?


America is on a never-ending quest to satisfy its sweet tooth without the health risks of sugar and other sweeteners. If you’re working to manage Hashimoto’s hypothyroidism, you probably know to avoid toxic artificial sweeteners such as aspartame and sucralose, but what about the more “natural” ones, such as xylitol, erythritol, and sorbitol? Although they’re found on the shelves of health food stores, it’s worth knowing a few things about these “natural” sweeteners.

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The good news about xylitol, erythritol, and sorbitol when you have Hashimoto’s hypothyroidism

Xylitol, erythritol, and sorbitol are sugar alcohols that are either poorly digested or poorly absorbed, which means they impart fewer calories and are less likely to raise blood sugar. Although they haven’t been studied much compared to artificial sweeteners, research of xylitol shows no negative effects except for gastrointestinal distress, which dissipated in some subjects in time. In fact, studies of diabetic rats showed xylitol improved health outcomes.

Xylitol is most well known for the prevention of tooth decay, better than fluoride in some studies.

Sugar alcohols also do not appear to confuse the body and raise blood sugar in the way artificial sweeteners do.

The bad news about xylitol, erythritol, and sorbitol when you have Hashimoto’s hypothyroidism

The downfall of sugar alcohols is that they can wreak havoc on digestive health and comfort. For people with Hashimoto’s hypothyroidism working to heal leaky gut this can be bad news. Because sugar alcohols are largely indigestible they pull water into the digestive tract and can cause diarrhea. Also, their indigestibility can cause them to ferment in the gut, causing bloating, gas, and distention. However, some people are able to adjust in a month or two and symptoms dissipate. Of the sugar alcohols, erythritol is the most easily digested and therefore causes the least gastric distress.

You probably need to keep sugar alcohols off the menu if you have small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), Crohn’s, or other digestive problems. It may also be a poor choice if you are on the autoimmune diet to repair your leaky gut or manage your autoimmunity.

People who are on the FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet also need to avoid xylitol, erythritol, and other sugar alcohols. This diet helps many people living with chronic gastric distress find relief by avoiding foods that are poorly digested and prone to fermenting in the gut.

Gut issues are common for people working to manage Hashimoto’s hypothyroidism and sugar alcohols may exacerbate the situation.

Using xylitol, erythritol, and sorbitol in your diet when you have Hashimoto’s hypothyroidism

If you’re trying to cut back on sugar and sugar alcohols don’t upset your stomach, you may find them a way to add some sweetness without the blood sugar spikes and consequent metabolic breakdowns that occur from eating sugars and other sweeteners regularly. However, they are not as sweet as sugar with a much milder sweetness. If you use too much to try and compensate you could be left with an unpleasant aftertaste. These sugars still have calories and carbohydrates, so if eaten in excess they can sabotage your efforts to improve your health by cutting back on sweets. You should also know that they are often derived from corn, much of which is genetically modified in the US, and an allergen for many.

The best way around fake sugars is to grow accustomed to a healthy, whole foods diet that only includes sweeteners on occasion. When you do not eat sweets regularly you begin to lose your taste for them, and you find a piece of fruit enormously satisfying and plenty sweet. A healthy diet low in sweeteners and void of foods that worsen gut health is also important to manage Hashimoto’s hypothyroidism.

Contact our team of professionals if you have questions or want to learn more!

Dr. Joni Labbe

About Dr. Joni Labbe

Dr. Joni Labbe is a board-certified clinical nutritionist specializing in science-based nutrition with a focus on women's health issues. She has successfully helped pre-menopausal and menopausal women regain and maintain their health since 1995. Dr. Labbe is the author of the Amazon #1 Best Selling book Thyroid & Menopause Madness and It’s Not Just Menopause: It’s Your Thyroid. She is also a professional speaker, radio personality, fitness expert, and former host of “Healthier Way With Dr. Labbe.” Dr. Labbe is one of the country’s leading authorities on thyroid disorders, including Hashimoto’s disease. Dr. Labbe has also authored numerous articles and blogs on health, nutrition, and thyroid health, as seen in Naturally Savvy, Thyroid Nation, and Fox News. She is a Board Certified Clinical Nutritionalist, Doctor of Chiropractic, and has post graduate training in Functional Neurology, Functional Endocrinology, Functional Blood Chemistry Analysis, and earned a Diplomate and Fellow in Nutrition from the American Association of Integrative Medicine.


  • Shabana says:

    Hi, my daughter is 7 yr old. I just found out, she has Hashimoto Hypothroid. I wanted to know if using a toothpaste with Xylitol is okay for my daughter. What kind of toothpaste should I use for her?

    • Dr. Joni Labbe says:

      I get asked quit regularly about xylitol, and have researched xylitol side effects to find out if it is really safe or not. No simple answer. Xylitol is a sugar alcohol, which is a low digestible carbohydrate. Gaining in popularity because it is “natural “In reality, Xylose, not xylitol, is naturally found in nature as it is mostly obtained from birch bark. “Natural” doesn’t necessarily mean it’s good for you.

      When foods that are eaten are normally digested, fats proteins carbohydrates are metabolized and absorbed. When chemical compounds like xylitol are consumed, the body cannot utilize them so they travel through your GI tract unabsorbed.

      Sometimes these chemicals can react with other foods and cause complications. In the case of xylitol this is generally experienced as GI disturbances such as bloating gas, digestion and elimination issues, exacerbating yeast problems and weight gain.

      It has been reported that xylitol can raise blood glucose levels, which suggests that diabetics shouldn’t use it. This seems odd to most people as many doctors recommend that people use xylitol to replace sugar because it’s low on the glycemic index.

      I’d be careful before diving in and making xylitol part of your daily natural health regime. It appears it is relatively safe as a toothpaste or chewing gum sweetener, but not recommended in large amounts for foods.

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