Xylitol – What the shit is going on here?

March 29, 2023
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Xylitol is used as a sugar substitute in such manufactured products as drugs, dietary supplements, confections, toothpaste, and chewing gum, but is not a common household sweetener. 

Xylitol has negligible effects on blood sugar because its assimilation and metabolism are independent of insulin. 

  •  “Xylitol”. Drugs.com. 2018. Retrieved 12 October 2018.
    • So I visited this source 3/29/23 and found the same statement but no explanation. That source cites the following four articles following that very brief section
      • Chandramohan G, Ignacimuthu S, Pugalendi KV. A novel compound from Casearia esculenta (Roxb.) root and its effect on carbohydrate metabolism in streptozotocin-diabetic rats. Eur J Pharmacol. 2008;590(1-3):437-443.18635165
      • Juśkiewicz J, Klewicki R, Zduńczyk Z. Consumption of galactosyl derivatives of polyols beneficially affects cecal fermentation and serum parameters in rats. Nutr Res. 2006;26(10):531-536.
      • Ly KA, Milgrom P, Rothen M. Xylitol, sweeteners, and dental caries. Pediatr Dent. 2006;28(2):154-163.16708791
      • Mäkinen KK. Can the pentitol-hexitol theory explain the clinical observations made with xylitol? Med Hypotheses. 2000;54(4):603-613.10859647

This is reportedly not the case with dogs. Xylitol is extremely poisonous to dogs because it “strongly promotes the release of insulin from the pancreas into circulation leading to a rapid decrease of blood glucose levels.” Ingesting 100 milligrams of xylitol per kilogram of body weight (mg/kg bw) causes dogs to experience a dose-dependent insulin release resulting in life-threatening hypoglycemia. The Pet Poison Helpline (PPH), states that xylitol causes hypoglycemia and hepatic necrosis in dogs. Hypoglycemia (low blood sugar) which can occur within 30 to 60 minutes of xylitol ingestion, and can lead to liver toxicity, liver damage, and consequently liver failure. At doses above 500 mg/kg bw, liver failure is likely and may result in coagulopathies like disseminated intravascular coagulation. Vomiting is a common first symptom, which can be followed by tiredness and ataxia. Signs of xylitol poisoning in dogs can include weakness, lethargy, collapse, vomiting, tremors, seizures, black-tarry stool, and even coma or death.

In 2011, EFSA approved a marketing claim that foods or beverages containing xylitol or similar sugar replacers cause lower blood glucose and lower insulin responses compared to sugar-containing foods or drinks.

Xylitol products are used as sucrose substitutes for weight control, as xylitol has 40% fewer calories than sucrose (2.4 kcal/g compared to 4.0 kcal/g for sucrose). 

The glycemic index (GI) of xylitol is only 7% of the GI for glucose.

A food is considered to have a low GI if it is 55 or less; high GI if 70 or more; and mid-range GI if 56 to 69. The term glycemic index (GI) was introduced in 1981 by David J. Jenkins and co-workers. It is useful for quantifying the relative rapidity with which the body breaks down carbohydrates. It takes into account only the available carbohydrate (total carbohydrate minus fiber) in a food. Glycemic index does not predict an individual’s glycemic response to a food, but can be used as a tool to assess the insulin response burden of a food, averaged across a studied population. Individual responses vary greatly. The glycemic index is usually applied in the context of the quantity of the food and the amount of carbohydrate in the food that is actually consumed. A related measure, the glycemic load (GL), factors this in by multiplying the glycemic index of the food in question by the carbohydrate content of the actual serving.

Xylitol is reportedly safe for rhesus macaques, horses, and rats.

A 2018 study suggests that xylitol is safe in cats in doses of up to 1000 mg/kg; however, this study was performed on only 6 cats, and should not be considered definitive.

Xylitol is approved as a food additive in the United States and elsewhere.

Some products that can contain xylitol are obvious, such as sugar free gum, toothpaste, and mouthwash.  Foods that contain xylitol include baked goods, peanut butter, drink powders, candy, pudding, ketchup, barbecue sauces, and pancake syrups.  Xylitol also appears in medications, especially those called “meltaways” or “fastmelts” and chewable vitamins. Because xylitol helps products retain moisture, it can even be an ingredient in products not intended to be eaten such as deodorants and lip balms.

Xylitol is not an artificial sweetener, and it can be present in products that are labeled as “naturally sweetened”.

Xylitol is also found as an additive to saline solution for nasal irrigation and has been reported to be effective in improving symptoms of chronic sinusitis.

Limited clinical trials exist to support use for any indication.

  • “Xylitol”. Drugs.com. Last updated on Apr 1, 2022 Retrieved 29 March 2023.

“Restoration of bowel motility after surgery” is probably due to the laxative effect.

When ingested at high doses, xylitol and other polyols may cause gastrointestinal discomfort, including flatulence, diarrhea, and irritable bowel syndrome; some people experience the adverse effects at lower doses.

Xylitol has a lower laxation threshold than some sugar alcohols but is more easily tolerated than mannitol and sorbitol.

  • Sugar Alcohols (PDF) (Report). Canadian Diabetes Association. 1 May 2005. Archived from the original (PDF) on 25 April 2012. Retrieved 14 March 2012.

Due to the adverse laxative effect that all polyols have on the digestive system in high doses, xylitol is banned from soft drinks in the European Union. Similarly due to a 1985 report, by the E.U. Scientific Committee on Food, stating that “ingesting 50 g a day of xylitol can cause diarrhea“, tabletop sweeteners, as well as other products containing xylitol are required to display the warning: “Excessive consumption may induce laxative effects”.

Xylitol has 2.4 kilocalories of food energy per gram of xylitol (10 kilojoules per gram) according to U.S. and E.U. food-labeling regulations. The real value can vary, depending on metabolic factors.

Primarily, the liver metabolizes absorbed xylitol. The main metabolic route in humans occurs in cytoplasm, via nonspecific NAD-dependent dehydrogenase (polyol dehydrogenase), which transforms xylitol to D-xylulose. Specific xylulokinase phosphorylates it to D-xylulose-5-phosphate. This then goes to pentose phosphate pathway for further processing.

About 50% of eaten xylitol is absorbed via the intestines. Of the remaining 50% that is not absorbed by the intestines, in humans, 50–75% of the xylitol remaining in the gut is fermented by gut bacteria into short-chain organic acids and gases, which may produce flatulence. The remnant unabsorbed xylitol that escapes fermentation is excreted unchanged, mostly in feces; less than 2 g of xylitol out of every 100 g ingested is excreted via urine.

Xylitol ingestion also increases motilin secretion, which may be related to xylitol’s ability to cause diarrhea. The less-digestible but fermentable nature of xylitol also contributes to constipation relieving effects.

Constipation relieving effects? It sounds like this stuff should be called X-lax, but only if it can’t be banned outright. It also sounds like it is about as healthy for humans as it is for dogs which is not at all. So many sickos.

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