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Oct 6, 2026, 16:43

Beth Shirley: Xylitol Consumption Increases Platelet Reactivity and Cardiovascular Risk

Beth Shirley, Director of Education and Research at Approved Medical Solutions, shared a post on LinkedIn:

“Xylitol Linked to Risk for Major Cardiac Events

Blogged about this 2 years ago

Posted that xylitol enhances multiple indices of platelet reactivity and in vivo thrombosis

Previously shown in population with high burden of CV risk factors already over a 3 year period

New info – even with no traditional CV risk factors, xylitol can increase cardiac events

Xylitol, aka birch sugar extracted from birch wood, is a 5 carbon sugar alcohol

Even though we can produce these sugar alcohols endogenously, they are 1000 fold lower than observed following consumption

Added to many consumer products

Labeled as ‘keto-friendly’, ‘diabetic friendly’, or sugar free

Candy and gum
Toothpaste
Nitrate chewing gum

This study ~18,000 participants, high levels in blood, associated with increased risk of CV events
Risk was Independent of many traditional CV risk factors including

Age
BMI
Bp
Diabetes
Lipid status
Smoking

After adjusting for traditional CV risk factors

Highest intake – greater risk for MACE (Major Adverse Cardiovascular Events)

Myocardial infarction
Stroke
Death
Consistent results across all subgroups

CV event 57 percent higher in those with highest level vs lowest level in 6 year follow up

Follow up period of 30 years, MACE was 18 percent higher

Suggests dose-dependent relationship

Their conclusion

‘In general population, we have shown that xylitol levels in blood are associated with event risk and based on known pro-thrombotic properties of xylitol, we can assume or speculate that even without overt CVD, xylitol portends risk in general population’.

Many people with these CV risk factors are looking to decrease sugar intake so they search for low to no calorie sweetener
These artificial sweeteners are widely accepted and embraced by modern society
However, these observational studies are showing a dark side to these sugar alcohols

Just say no to these sugar alcohols
While xylitol may have some positive effects on NO, its tendency to increase platelet activity and thrombosis raises considerable concern about CV health…..”

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