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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.

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.