Artificial Sweeteners and Blood Clots: Should You Be Concerned?

Staying hydrated is important year-round, but especially in the summer heat. Many people choose sugar-free drinks and low-calorie sodas to cut back on sugar. But what’s actually in a “sugar-free” beverage?? Artificial sweeteners help reduce sugar intake—but they may come with risks of their own, including possible effects on your heart and blood vessels.

Are Artificial Sweeteners Linked to Blood Clots?

Artificial sweeteners aren’t just found in drinks. They’re often an ingredient in protein bars, baked goods, and foods labeled “low sugar” or “keto-friendly.” One of the most common sweeteners is erythritol, a sugar alcohol often used in low-carb products.

A 2024 study published in Arteriosclerosis, Thrombosis, and Vascular Biology found that drinking a sugar-free beverage with about 30 grams of erythritol made the amount of erythritol in the blood rise sharply—more than 1,000 times higher than before drinking it. This spike was linked to changes in platelets, the cells that help blood clot. After consuming erythritol, participants’ platelets showed signs of increased activity, which could potentially make the blood more prone to forming clots. This response was seen consistently across all participants in the study.

Researchers noted that these findings, combined with earlier research linking higher erythritol levels to heart attack and stroke risk, suggest erythritol’s safety may need further investigation.

Although more studies are needed, people with heart disease, diabetes, high blood pressure, or a history of blood clots should be cautious about consuming erythritol regularly.

How Safe Are Sweeteners? What the FDA Says

According  to the U.S. Food and Drug Administration (FDA),all approved food additives and sweeteners classified as GRAS (Generally Recognized as Safe) are  safe when used as intended.

 If you wish to avoid artificial additives, plant-based sweeteners like stevia or monk fruit are another option.

What Do “Approved” and “GRAS” Mean?

• Approved Food Additive: The FDA formally reviewed safety studies and approved the ingredient for specific uses in food and beverages.
  
  

• GRAS (Generally Recognized as Safe): Some ingredients don’t need formal FDA approval because there’s already strong scientific agreement that they’re safe. This is known as GRAS status. While these ingredients haven’t gone through the FDA’s full food additive approval process—which includes submitting safety studies for FDA review—they must still be supported by solid research and widely accepted by experts to be used in food and drinks.

Source for image: U.S. Food and Drug Administration (FDA)

Where Are These Sweeteners Found?

According to Kourtney Johnson, a registered dietitian and health content writer, artificial sweeteners are more common than many people realize.

"Reading the nutrition label is key," Johnson says. "Look for FDA-approved sweeteners like acesulfame potassium, neotame, and advantame. Sugar alcohols like erythritol typically end in 'tol,' or may simply be listed as 'sugar alcohols.' Products labeled 'diet,' 'light,' or 'low calorie' are also clues."

Johnson adds that many people think of diet soda and juice as typical sources of artificial sweeteners, but products like “light” applesauce, yogurt, and even kettle corn often contain sugar alcohols or other types of artificial sweeteners.

What Experts Say About Health Risks

"The use of artificial sweeteners and their impact on health have been studied extensively," says Johnson. "Research shows potential concerns, including increased risks of type 2 diabetes, cardiovascular events, stroke, and changes to the gut microbiota."

Despite these concerns, Johnson notes that the FDA has approved sweeteners like aspartame, sucralose, and saccharin as safe for use in food.

"The FDA determines safety based on estimated daily intake compared to acceptable daily intake levels. As long as people stay within those limits, these additives are considered safe," she explains. This includes sugar alcohols like erythritol and sorbitol.

The American Diabetes Association (ADA) agrees that sweeteners like sucralose, aspartame, stevia, and xylitol can help reduce sugar and calorie intake when used in place of sugary foods and drinks. However, they note that these sweeteners don’t seem to help with weight loss unless part of a broader effort to reduce overall calories.

Emerging research further suggests that artificial sweeteners may affect the body in other ways, such as:

• Changing gut bacteria

• Disrupting how the body processes sugar

• Confusing the body’s connection between sweet taste and actual calories

The World Health Organization (WHO) recommends limiting artificial sweeteners—not just because they don’t help with long-term weight control, but also due to their link to type 2 diabetes, heart disease, and early death. However, WHO classifies this recommendation as conditional, since evidence about harms remains uncertain.

A Balanced Approach to Sweetness

Johnson emphasizes that avoiding artificial sweeteners entirely isn’t necessary—or realistic—for most people.

"Artificial sugars, like many nutrition topics, aren’t black and white. I wouldn’t tell people to avoid them entirely. They’re sometimes added to useful products, like no-sugar-added canned fruit," she says. "In 2019, the CDC reported that only 12% of adults ate the recommended amount of fruit, and just 10% ate enough vegetables. If artificial sweeteners help someone access canned fruits, that’s still a win. Increasing fruits and veggies matters more than small amounts of sweeteners."

She also encourages people to choose natural sweetness when possible.

"Eating fruit is a great way to enjoy something sweet that’s more nutrient-dense with fiber and vitamins. I also think that foods made with real sugar often taste better, so I’d encourage people to enjoy a piece of cake or a couple of cookies every so often instead of opting for sugar-free options more often—which, in addition to artificial sweeteners, still contain carbs and impact blood sugar like regular products."

Final Takeaway: Should You Be Concerned?

Artificial sweeteners can be part of a balanced diet when used sparingly. But if you have cardiovascular risk factors, such as high blood pressure, diabetes, or a history of blood clots, limiting your intake—especially of erythritol—may be wise. Instead…

• Choose plant-derived options like stevia or monk fruit when possible.

• Focus on real, whole foods for natural sweetness.

• Use sugar-free products occasionally, not daily.

As Johnson sums up:

"Do what you can to avoid artificial sugars while taking your unique situation into account."

Meet our Expert

Kourtney Johnson, RD, LD, earned her Bachelor of Science in Dietetics from St. Catherine University in St. Paul, MN. While she has experience working in the clinical setting, her passion is writing nutrition and diabetes content. She has written for outlets such as Beyond Type 1, Well+Good and Navitas Organics.

References

American Diabetes Association Professional Practice Committee. 5. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes—2025. Diabetes Care. 2025;48(Suppl 1):S86–S127. doi:10.2337/dc25-S005

Aspartame and other sweeteners in food. U.S. Food and Drug Administration. Updated July 3, 2023. Accessed July 23, 2025.

Iizuka K. Is the use of artificial sweeteners beneficial for patients with diabetes mellitus? The advantages and disadvantages of artificial sweeteners. Nutrients. 2022; 14(21):4446. https://doi.org/10.3390/nu14214446

Understanding how FDA regulates food additives and GRAS ingredients. U.S. Food and Drug Administration. Updated February 6, 2024. Accessed July 23, 2025.

Witkowski M, Nemet I, Alamri H, et al. The artificial sweetener erythritol and cardiovascular event risk. Nat Med. 2023;29(3):710-718. doi: 10.1038/s41591-023-02223-9. PMID: 36849732; PMCID: PMC10334259.

Witkowski M, Wilcox J, Province V, et al. Ingestion of the non-nutritive sweetener erythritol, but not glucose, enhances platelet reactivity and thrombosis potential in healthy volunteers—brief report. Arterioscler Thromb Vasc Biol. 2024;44(9):2136-2141. doi:10.1161/ATVBAHA.124.321019.

WHO advises not to use non-sugar sweeteners for weight control in newly released guideline. World Health Organization. Published May 15, 2023. Accessed July 23, 2025.