Many different types of sweeteners are used to make sugar-free products. Some of these are natural sweeteners like stevia while others are artificial sweeteners like sucralose. Artificial sweetener allergy issues are rare and you're more likely to be allergic to natural sugar substitutes.
Natural vs. Artificial Sugar-Free Products
There are many different types of natural and artificial sugar-free products. According to the Cleveland Clinic, there are eight different non-nutritive sugar substitutes that have been approved by the Food and Drug Administration (FDA).
You're probably familiar with artificial sweeteners like sucralose, aspartame and Splenda (which is a mixture of sucralose and maltodextrin). These are the sugar-free alternatives that you'll most often find in diet beverages, sugar-free yogurts and reduced-calorie products. Other FDA-approved artificial sweeteners include neotame, saccharin, acesulfame potassium, sucralose and advantame.
There are two natural sugar substitutes that are FDA-approved, as well. These are monk fruit extract (also known as luo han guo extract) and stevia, which is extracted from stevia plant leaves.
In addition to these non-nutritive artificial and natural sugar substitutes, the FDA has also approved sugar alcohols like isomalt, xylitol and sorbitol. Sugar alcohols are produced from a wide variety of different plants, including corn, rice, barley and birch.
As you can see, these sugar substitutes are all made in different ways and come from different sources. It's consequently possible to have an artificial sweetener allergy but not a sugar alcohol allergy. Alternatively, you might have an isomalt allergy but be perfectly fine consuming stevia.
Read more: The Ultimate Guide to Natural Sweeteners
Side Effects of Sugar Substitutes
Regardless of where they come from or how they're produced, sugar substitutes have side effects. You should be aware of these side effects so that you don't confuse them with allergy symptoms.
For example, according to a January 2014 article in the Journal of Biology, Agriculture and Healthcare, artificial sweeteners have been associated with a variety of side effects, including:
- Migraines and headaches
- Skin problems
- Weight gain
- Organ problems
Sugar alcohols are also well known for causing a variety of side effects, most of which are gastrointestinal. However, these side effects typically occur when they're consumed in excess. According to a February 2017 article in the International Journal of Advanced Academic Research, consumption of large amounts of sugar alcohols can cause result in:
- Unintentional weight loss
Read more: The 12 Best and Worst Sugar Substitutes
Allergic Reactions to Sugar Alcohols
Sugar alcohols are known for causing unpleasant gastrointestinal side effects. However, these gut problems are usually accompanied by other symptoms when an allergy occurs.
According to a January 2015 study in the Clinical Aspects Journal, allergic reactions also tend to involve respiratory symptoms like swelling of the throat and difficulty breathing. In severe cases, people will also experience anaphylaxis.
Fortunately, allergic responses to sugar alcohols is rare. However, according to both the study in the Clinical Aspects Journal and a January 2014 study in the journal Allergology International, allergic reactions to erythritol, xylitol, mannitol and sorbitol are certainly possible.
Allergic reactions to every single sugar alcohol have not yet been reported. However, these studies show that an isomalt allergy and reactions to similar sugar alcohol products are certainly possible.
More recently, a January 2019 study in _Allergology International _discussed how rare it is to be allergic to most sugar alcohols, especially ones like xylitol. Chemically, xylitol is small and doesn't have any reactive components, which means that it's less likely for your body to consider it a threat.
However, keep in mind that sugar alcohols can be made from many different plants. For example, an allergy to birch pollen might mean you're allergic to birch xylitol or even xylitol that's made from a species of tree that's similar to birch. Once your body responds to birch xylitol, it might also be more likely to respond to other types of xylitol.
Allergic Reactions to Stevia
According to a January 2015 study in the Journal of Food and Chemical Toxicology, hypersensitivity and allergies to stevia are rare. However, various different cases have been reported.
Stevia allergy symptoms can vary based on the type of stevia sweetener that was consumed. People have had allergic reactions to whole stevia leaves, stevia sweeteners and food products that contain stevia.
The article in the Journal of Food and Chemical Toxicology says that symptoms of stevia hypersensitivity have been reported as nausea, vomiting, dizziness and fainting. Stevia allergies, on the other hand, tend to involve changes in blood pressure, swelling and anaphylactic shock.
People who are allergic to certain plants like ragweed, mugwort and sunflower might be at increased risk for stevia hypersensitivity or allergy. This is because all of these plants come from the same family. Their similarity means that your body might perceive stevia as an allergen, too.
Artificial Sweetener Allergy Issues
Very few artificial sweeteners are listed as potential allergens. The scientific literature on this subject is very limited and reported cases of allergic reactions are all fairly mild. This means that artificial sweeteners are unlikely to cause you serious allergic reactions or anaphylaxis.
A December 2012 review in the Journal of Paediatrics and Child Health reported that aspartame is capable of causing hives. However, artificial sweeteners and hives aren't typical, and there are no other recent publications discussing this phenomenon.
Similarly, a January 2014 report in the Journal of Contact Dermatitis discussed how consumption of acesulfame potassium could lead to lip and facial swelling, sinus congestion and difficulty breathing. However, this artificial sweetener allergy is also rare.
Although artificial sweeteners are less likely to induce serious allergic reactions and anaphylaxis, these sweeteners may have long-term effects on your health. Several scientific studies, like a June 2016 study in the Indian Journal of Pharmacology, have questioned the side effects these products have and the way they can affect your digestive system.
Although their use is approved by the FDA, you may want to be conscious of how often you consume artificial sweeteners. Regular to excessive consumption has the potential to increase your risk for certain conditions, including cardiovascular disease, kidney disease, diabetes and obesity.
- Cleveland Clinic: "Sugar Substitutes & Non-Nutritive Sweeteners"
- Food and Drug Administration: "Sugar Alcohols"
- Journal of Biology, Agriculture and Healthcare: "A Review on Potential Toxicity of Artificial Sweetners vs Safety of Stevia: A Natural Bio-Sweetner"
- International Journal of Advanced Academic Research: "Sugar Alcohols: Chemistry, Production, Health Concerns and Nutritional Importance of Mannitol, Sorbitol, Xylitol, and Erythritol"
- Clinical Aspects: "Food Allergy: Molecular Basis and Clinical Practice"
- Allergology International: "Detection of Sugar Alcohol-Specific IgE"
- Allergology International: "Anaphylaxis to Xylitol Diagnosed by Skin Prick Test and Basophil Activation Test"
- Food and Chemical Toxicology: "Steviol Glycoside Safety: Are Highly Purified Steviol Glycoside Sweeteners Food Allergens?"
- Journal of Paediatrics and Child Health: "Intolerance to Food Additives – Does It Exist?"
- Contact Dermatitis: "Allergic Reaction Caused by Acesulfame Potassium in Foods."
- Indian Journal of Pharmacology: "Artificial Sweeteners as a Sugar Substitute: Are They Really Safe?"