Is Xylitol Good For You? -

Is Xylitol Good For You?


Is Xylitol Good For You?

Xylitol is a sweetener that seems to be winning the popularity contest amongst consumer’s desire for no calorie sweeteners. Claims support that it is “all natural”, safe for diabetic and the American Academy of Pediatric Dentistry supports the use of xylitol for oral health benefits (5).

But is xylitol good for you and should it be classified as a healthy sweetener? Depending on your health circumstances, you may want to avoid xylitol intake when possible or other otherwise limit your daily consumption.


What is Xylitol?

Xylitol is a type of sugar alcohol known as a polyol and categorized along with other popular sweeteners you may have heard of including sorbitol, mannitol, lactiol and maltiol. Such sweeteners are created in a process known as “hydrogenation”- a process you have likely already heard of in many processed foods harmful to health. (1)

Although xylitol can be found naturally occurring in small concentrations of foods like berries, cauliflower and plums, xylitol is typically prepared from its original form xylose (2). Compounds that make up xylose are chemically swapped for oxygen and hydrogen resulting in the low glycemic sweetener xylitol (1). This fact that xylitol is found in nature and is derived from a natural product allows government authorities to loosely regulate the labeling requirements of food manufacturers.

Numerous studies report that xylitol has no effect on blood glucose levels and in fact it is broken down in a process that does not rely on insulin secretion.  Xylitol cannot be fully digested and absorbed within the human gastrointestinal tract and up to 20% of this compound is shown to be excreted in urine. In fact, only 50% of xylitol is understood to be absorbed by the small intestine begging the concern that this sweetener may have toxic effects from accumulating in the liver. (1)

Oral Health Benefits

Xylitol is largely found in oral hygiene products including toothpastes, mouthwash, chewing gums, and mints and is intended to promote therapeutic benefits for oral health.


If we do not yet fully understand where all components of xylitol is broken down and absorbed in the body, why has it gained popularity you should ask? Xylitol has antimicrobial defenses against infectious bacteria such as pneumococcus known to cause pneumonia and meningitis. Xylitol prevents growth of harmful bacteria likely by causing a toxic effect within the encapsulated bacterium. (3)

In order to reap the antimicrobial benefits of xylitol, it is recommended to consume products only containing pure xylitol without any other added sweeteners or in combination with foods containing sweetener. The presence of other sugars and sugar substitutes with xylitol inhibits xylitol’s ability to degrade and prevent bacteria growth (3).


The World Health Organization (WHO) classifies acetaldehyde as a highly toxic class 1 carcinogen. In other words, acetaldehyde is a compound sufficiently evidenced well enough to be labeled cancer causing in humans. This mutagenic product results from alcohol fermentation that harmful bacteria in the mouth can produce in large quantities. When ethanol found in alcohol is mixed with saliva, a reaction occurs to create acetaldehyde. (4)

Xylitol has been shown to inhibit microbes from producing acetaldehyde during the fermentation process. Xylitol can even completely eliminate this carcinogenic activity for some bacterial strains. The concentrations of xylitol used in such studies support that this anti-carcinogenic property can be obtained from chewing xylitol sweetened gum often throughout the course of a single day.

Lung Cancer Therapy:

A new study recently performed experimental treatment involving the effects of xylitol on cancer cells. What researchers found is that xylitol actually may have therapeutic benefits at treating lung cancer. Xylitol was shown to inhibit cell proliferation of specific lung cancer cells and allow for natural cell destruction of cancer cells, a process known as autophagy. (6)

Warnings for Xylitol Consumption

Xylitol may sound like the perfect sweetener suitable for consumption by all individuals but it does not come without pitfalls.  Unfortunately, conflicting evidence supports whether or not xylitol is a good sweetener because long term studies are limited in assessing its effects on health.

Potential for Metabolic Disturbance:

As previously mentioned, xylitol is not fully absorbed by the GI (gastrointestinal) tract. Therefore it may be likely that xylitol accumulates in the liver and may have toxic consequences when used in large quantities over extended periods and may lead to metabolic disturbances.


Gastrointestinal Upset:

Xylitol is in a class of fermentable carbohydrates called polyols.  A large quantity of xylitol is passed to the colon and fermented by bacteria. The microflora here utilizes the sweetener to produce fatty acids as well as hydrogen and methane gas. As a result, these gases are associated with gas, abdominal cramping, bloating, constipation and diarrhea (5).

Evidence suggest that more than 10 grams of xylitol daily can cause these GI symptoms which may be easily consumed unknowingly due to its increase in presence in products but not on labels. (1)  As a result, individuals with gastrointestinal issues sensitive to fermentable sugars should avoid xylitol. People with gut complications such as irritable bowel syndrome, small intestinal bacterial overgrowth (SIBO) and Crohn’s disease may experience an increase of GI disturbances exacerbated by xylitol.



What foods you consume with xylitol and various nutritional components of foods containing xylitol may affect your ability to absorb each component. Ingesting sugar alcohols can limit the ability for other nutrients like fats and carbs to be properly metabolized.

Clinical trials have also shown that consumption of sweeteners like xylitol can cause appetite dysregulation resulting in a lack of satiety and an overall increase in fat consumption. (1)


Drug Contraindications:

As a whole group, sugar alcohols can interact with drugs (1). Especially those drugs used by diabetics to manage weight should limit xylitol consumption.

Caution for Pet Owners:

Too many instances of dogs ingesting foods containing xylitol have left pet owners with tough lessons to be learned. The amount of xylitol found in a few cookies, a pack of gum and even English muffins is enough of the compound to cause severe hypoglycemica (low blood sugar) and life threatening liver failure in man’s best friend (7).


Although xylitol is a healthier alternative than sugar and high fructose products like agave, xylitol is best in small quantities even in the healthiest of people. 

Sources for this Article Include:

  1. Wolever T, Piekarz A, Hollands M, and Younker K. Sugar Alcohols and Diabetes: A Review. Can J Dia. 2002; 26(4): 356-362 Link Here
  2. Amo K, et al. Effects of xylitol on metabolic parameters and visceral fat accumulation. J Clin Biochem Nutr. 2011 Jul; 49(1): 1-7. PMCID: 3128359
  3. Tapiainen T, et al. Effect of Xylitol on Growth ofStreptococcus pneumoniae in the Presence of Fructose and Sorbitol. Antimicrobial Agents and Chemotherapy. 2001;45(1):166-169. PMCID: 90255
  4. Uittamo J, et al. Xylitol inhibits carcinogenic acealdehyde production by Candida species. Int J Cancer. 2011 Oct; 129(8):2038-41. PMID: 21154745
  5. American Academy of Pediatric Dentistry: Policy on the Use of Xylitol Link Here
  6. Park E, Park MH, Na and Chung J. Xylitol induces cell death in lung cancer A549 cells by autophagy. Biotechnol Lett. 2015 May; 37(5):983-90. PMID: 25650339
  7. Piscitelli CM, Dunayer EK, and Aumann M. Xylitol toxicity in dogs. Compend Contin Educ Vet. 2010 Feb; 32(2):E1-4. PMID: 20473849


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14 Responses to Is Xylitol Good For You?

  1. Pat February 16, 2016 at 9:57 am #

    I find that xylitol leaves a burning sensation in my oral mucosa which progresses to an actual inflammation. Anyone that I mention this to has found this symptom to be unusual.

    • Dr. Jockers February 16, 2016 at 10:00 am #

      Yes that is an unusual experience Pat. Obviously, you are having some sort of an allergic reaction to it.

      • pat February 16, 2016 at 10:21 am #

        Thanks for your comment. I’m curious if anyone else has information about reactions to sugar alcohols.

        • Al February 16, 2016 at 8:24 pm #

          xylitol is a deadly poison to dogs. I bought coconut swirls at the grocery chain, quite a few times, & was giving my large dog 2-3 + swirls out of each box, 5 or 6 boxes later he would run around in the back yard, fall on his side & have a seizure. This happened for about a month.Took him to vet. I had to carry him in because he could not navigate by himself. I had to put him to sleep (that hurt). Searching the web. I found confirmation of it’s being a deadly poison to dogs. This is a further distillation of corn syrup. On every item that uses xylitol, There is no warning of it being poison to dogs. Again FDA falls flat on their promise to investigate food sold to the consumer.
          They even put xylitol into Flintstones vitamins for children.
          The FDA is definitely not on the side of the consumer

          • Dr. Jockers February 16, 2016 at 9:49 pm #

            Al, xylitol is poisonous to dogs, just as chocolate and onions are, but not to humans. However, for those with GI issues, in particular, Small intestinal bacterial overgrowth, it can cause gas and bloating.

  2. Amy February 16, 2016 at 4:36 pm #

    Would it be good to melt the xylitol in water and use it as an oral rinse to get the anti-cavity benefits?

    • Dr. Jockers February 16, 2016 at 4:46 pm #

      That is a great idea and there are toothpastes made with xylitol in them!

  3. Margaret February 16, 2016 at 5:29 pm #

    i’ve been using Xlear nose spray to control my chronic rhinitis daily . It contains xylitol.I also have IBS and multiple food sensitivities.What are your thoughts , should I stop using it?

    • Dr. Jockers February 16, 2016 at 9:50 pm #

      It is probably just fine, but if you notice increased gas and bloating when using it, than it would be good to eliminate for a while and then add back to see if it is contributing.

  4. Guadalupe Kurtzman March 11, 2016 at 6:37 pm #

    Xylitol can be processed from trees like birch , but it can also be made with an industrial process that transforms a plant fiber called xylan into xylitol.

    • Dr. Jockers March 12, 2016 at 5:06 am #

      Thank you so much for the info Guadalupe!

  5. Monica July 23, 2016 at 10:23 am #

    These are pub med articles citing 2 instances where xylitol used in parenteral (post surgical) nutrition as a glucose substitute caused seizures and renal failure in humans. One, a 24 year old male died. In both instances, xylitol was the established cause. It’s not recommended for epileptics. Maybe it’s bioindividuality but how can a person know how they’ll respond? The two gentlemen cited in the pub med abstracts were not established epileptics. The FDA has recommended limited amounts for children. Our experience is that it does indeed induce seizures in those with a predisposition/history.

    • Dr. Jockers July 25, 2016 at 7:34 pm #

      Thank you for the research Monica! I will advise against using this for individuals with seizure disorders.

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