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Xylitol is the alcohol form of xylose, which is used as a sweetener in chewing gums and other dietetic products. Xylitol has less effect on blood sugar or insulin levels compared with sucrose,1 so it may be a useful sugar substitute for diabetics.2 In addition, xylitol inhibits the growth of several types of bacteria, including those that cause tooth decay and ear infections.3 4 5 6

Where is it found?

Xylitol occurs naturally in straw, corncobs, fruit, vegetables, cereals, mushrooms, and some seaweeds. For use in food manufacturing, xylitol is extracted from birch wood chips. Xylitol may be found in many foods labeled as "sugar-free," including hard candies, cookies, chewing gums, soft drinks, and throat lozenges.

Xylitol has been used in connection with the following conditions (refer to the individual health concern for complete information):

Science Ratings Health Concerns

Ear infections

Tooth decay

3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

Who is likely to be deficient?

Xylitol is not an essential nutrient; therefore, no deficiencies are possible.

How much is usually taken?

For prevention of dental caries (cavities), 7 to 20 grams per day are given, divided into several doses in candies or chewing gum. For prevention of ear infections, 1.7 to 2.0 grams are given fives times per day in gum, lozenges, or syrup.

Are there any side effects or interactions?

Xylitol is recognized as a safe food additive by the U.S. government.7 Large amounts (30 to 40 grams) taken all at once can produce diarrhea and intestinal gas.

At the time of writing, there were no well-known drug interactions with xylitol.


1. Hassinger W, Sauer G, Cordes U, et al. The effects of equal caloric amounts of xylitol, sucrose and starch on insulin requirements and blood glucose levels in insulin-dependent diabetics. Diabetologia 1981;21:37–40.

2. Bakr AA. Application potential for some sugar substitutes in some low energy and diabetic foods. Nahrung 1997;41:170–5.

3. Trahan L. Xylitol: a review of its action on mutans streptococci and dental plaque—its clinical significance. Int Dent J 1995;45(1 Suppl 1):77–92 [review].

4. Tapiainen T, Kontiokari T, Sammalkivi L, et al. Effect of xylitol on growth of Streptococcus pneumoniae in the presence of fructose and sorbitol. Antimicrob Agents Chemother 2001;45:166–9.

5. Kontiokari T, Uhari M, Koskela M. Antiadhesive effects of xylitol on otopathogenic bacteria. J Antimicrob Chemother 1998;41:563–5.

6. Kontiokari T, Uhari M, Koskela M. Effect of xylitol on growth of nasopharyngeal bacteria in vitro. Antimicrob Agents Chemother 1995;39:1820–3.

7. Xylitol. Code of Federal Regulations, Title 21, Volume 3. U.S. Government Printing Office, 2003: 21CFR172.395.

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