Xylitol
Last reviewed October 18, 2026 · Evidence strength: Limited · How we grade evidence
In plain words: Xylitol is a sugar alcohol used in sugar-free gum, mints and toothpaste. It's gentle on teeth and blood sugar. But a 2024 study linked high blood xylitol to heart attack and stroke risk, so people with heart risk may want to avoid large amounts. And it's extremely poisonous to dogs.
Also listed on labels as: Xylitol, Birch sugar, E967
What is it, and why is it in food?
Xylitol is about as sweet as sugar with fewer calories and little effect on blood sugar. It's made from birch wood or corn cobs. Most xylitol in US packaged foods is in gum and mints; it's also sold as a baking sweetener and used in toothpaste.
What does the science say?
| The popular claim | "Xylitol is a good low-glycemic choice, suitable for diabetics." (Dr. Eric Berg; on Dr. Steven Gundry's "Yes" list.) |
| Our verdict on that claim | Partly supported |
| Evidence strength | Limited: one population study of blood levels plus a small experiment; no outcome trials. |
| Kinds of studies | Population study, small human experiment, regulations |
- Heart: People with the highest blood xylitol had a 57% higher risk of major heart events over 3 years. In volunteers, a xylitol drink made platelets stickier and promoted clotting in lab tests.1 This is a link, not proof, and the amounts in a piece of gum are far smaller than the test drink.
- Digestion: Like other sugar alcohols, larger amounts cause gas and diarrhea.
- Teeth: Xylitol in gum and toothpaste is widely used for its tooth-friendly properties, though our research didn't review the dental studies in detail.
What do regulators say?
- US: permitted; foods high in polyols may carry laxative warnings.
- EU: authorized as E967, with a laxative warning on foods with more than 10% polyols.
Who should be careful?
- People with heart disease or clotting risk: avoid large amounts, like xylitol baking sweeteners or many sugar-free treats a day. Gum is a much smaller dose.
- Dog owners: keep all xylitol products out of reach.
How common is it in US foods?
In our check of USDA's Branded Foods database, 1,004 of 438,129 US packaged foods with an ingredient list name xylitol (about 0.2%, or roughly 1 in 436).2 It shows up most often in: chewing gum & mints (621); candy (71); chocolate (64); ice cream & frozen yogurt (55); snack, energy & granola bars (26). About 6 in 10 of those are gum and mints. These are label records companies sent to USDA, mostly in 2021 to 2023, so some products have changed since. Counts come from a text match of ingredient lists and are approximate.
Swaps and tips for families
- Xylitol gum after meals is fine for most people.
- For baking, consider a smaller amount of regular sugar instead of cup-for-cup xylitol.
Beyond the plate: related non-food exposures
Dogs: xylitol is extremely toxic to dogs. It causes a sudden drop in blood sugar and liver failure. Check gum, candy, some peanut butters, chewable vitamins and toothpaste. If your dog eats any, call your vet or a pet poison line right away. For people, xylitol toothpaste and gum are fine and can help teeth.
Frequently asked questions
Is xylitol bad for your heart?
It's not proven. A 2024 study linked high blood xylitol to heart events and found it made platelets stickier. People with heart risk may want to skip large amounts.
Is xylitol gum safe?
For people, yes, in normal amounts. A piece of gum has far less xylitol than the amounts tested in the heart study.
How much xylitol is toxic to dogs?
Very little. Even a few pieces of gum can poison a small dog. Treat any amount as an emergency and call your vet.
Related guides
Sources
Every source below was checked against PubMed, the publisher or the official page by our research team in October 2026.
- Xylitol is prothrombotic and associated with cardiovascular risk. European heart journal, 2024. PubMed 38842092 · doi:10.1093/eurheartj/ehae244
- FoodData Central, Branded Foods dataset (release 2026-04-30). U.S. Department of Agriculture, Agricultural Research Service, 2026. Link
- 21 CFR 184.1835 Sorbitol. Link
This guide is for general education. It is not medical advice and does not replace advice from your doctor, pediatrician, allergist or registered dietitian. If you think you or your child reacted to a food, talk to a health professional. Research changes; we review these pages when new evidence or rules come out. Last reviewed October 18, 2026. Spotted an error? Email [email protected].