Medically Reviewed by Christine Mikstas, RD, LD on May 20, 2021

Xylitol is a carbohydrate found in the birch tree and several kinds of fruit. It has a chemical structure that looks like a cross between a sugar and an alcohol, but it is neither.

Why do people take xylitol?

Xylitol is a sugar-free sweetener added to some foods. It's nearly as sweet as sugar (sucrose), but has fewer calories.

People with diabetes sometimes use xylitol as a sugar substitute. Blood sugar levels stay at a more constant level with xylitol than with regular sugar. This is because it is absorbed more slowly by the body.

Some types of gum or oral care products, such as toothpaste and mouthwash, also contain xylitol. Mouth bacteria can't use xylitol as a source of energy, so it may help prevent tooth decay and the buildup of plaque.

Researchers have studied the use of xylitol to prevent sudden attacks of middle ear inflammation (otitis media) in children with frequent earaches. One way it may help is by inhibiting the growth of bacteria. More studies are needed to confirm its effectiveness for this and other uses.

Optimal doses of xylitol have not been set for any condition. Quality and active ingredients in supplements may vary widely from maker to maker. This makes it difficult to set a standard dose.

Can you get xylitol from foods?

Xylitol is extracted from plant material. The amount naturally found in foods is very small.

However, it is increasingly found as an ingredient (additive) in more and more foods and health products. In addition to gum, xylitol can be found in some hard candies, chocolate, table syrup, jams, jellies, baked goods, cough syrup, vitamins, some nut butters, over-the-counter medications and many others.

What are the risks of taking xylitol?

Xylitol is mostly safe, especially if taken in amounts found in food. The FDA has approved xylitol as a food additive or sweetener.

Side effects. If you take large amounts of xylitol, such as 30 to 40 grams, you may experience diarrhea or gas. Increasing the dose gradually may help minimize these effects.

Risks. There is not enough information to confirm xylitol's safety in pregnant and breastfeeding women, so they should not use it for medicinal purposes. Although some animal studies have shown tumor growth resulting from high doses of xylitol over long periods, more research is needed.

If you are a dog owner, be aware that xylitol can be toxic to dogs, even in small amounts.

Interactions. Doctors don't know of any interactions with other herbs, supplements, drugs, or foods.

Tell your doctor about any you're taking, even if they're natural. That way, your doctor can check on any potential side effects or interactions with medications, foods, or other herbs and supplements.

Show Sources


Natural Medicines Comprehensive Database: "Xylitol."

Food Insight: "Background on Carbohydrates & Sugars," "Sugar Alcohols Fact Sheet."

Canadian Diabetes Association: "Sweeteners."

Amo, K. Journal of Clinical Biochemistry and Nutrition, July 2011.

Bope, E. Conn's Current Therapy 2013, Saunders Elsevier, 2013.

Schmid RD. Acute Hepatic Failure in a Dog after Xylitol Ingestion. 2016

Azarpazhooh A.  Xylitol for preventing acute otitis media in children up to 12 years of age. August 2016.

FDA: Paws Off Xylitol; It's Dangerous for Dogs.

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