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Erythritol and PVCs

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Anonymous
 Anonymous
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I came here because I saw the other thread about PVCs which mentioned erythritol. I have been trying to collect as much information as possible about the connection as I am thinking I may be sensitive to erythritol. Whenever I reduce my erythritol intake, my PVCs become less frequent. I'm starting to think now that I psyche myself up and the anxiety alone may cause more skipped heart beats, but it seems there are other people who have noticed the same connection. It is so hard to know for sure though as it seems so many different things go into causing PVCs. I've started to get more and more used to them, but they also make me nervous at times. I'd be curious what other information people have found on the topic, or even just personal experiences.


   
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DrDave
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I've noticed this post sitting here and realized I should share what information I can find on the topic.  Remember, I am not giving medical advice, but I am sharing information that I have found elsewhere, and that I feel is reliable information.  

 
First, what is erythritol?
 
Erythritol is in the category of naturally derived non-nutritive sweetener (abbreviated NNS). Specifically, erythritol is a glycoside NNS in the polyol (sugar alcohol) category.  Other polyol sweeteners are xylitol and sorbitol.
 
You can read this article for a detailed overview of erythritol and how it compares to sorbitol and xylitol.  The article supports that erythritol is better for anti-cavity properties compared to the others. 
 
 
Erythritol was approved for human consumption in 1990 and there has been extensive testing for safety, and I've had a hard time finding any studies suggesting negative problems.  That doesn't mean that some people aren't sensitive to it, but based on large studies, erythritol seems to be safe.
 
I fact, a few studies suggest it may have anti-inflammatory properties, but these are small studies and not conclusive to me.  One study was a pilot study looking at endothelial function and another was looking at small intestine inflammation.  Both suggested a reduction with erythritol.  
 
 
Having said all of that about erythritol being safe and not seeing adverse events report, I do find some reports from individuals such as those posted in another thread on palpitations and PVCs (so called anecdotal reports) that they have experienced palpitations (irregular heart beats) after ingesting foods that contain erythritol.  
 
Searching around various websites online, I was able to find similar reports to what I've seen here - that people have reported palpitations and they associate it with foods that contain erythritol.  A few of the reports were more specifically referring to Truvia, in which erythritol is one of the main ingredients.  Stevia leaf extract is the main sweetener in Truvia, with erythritol used as both a sweetener and a bulking agent.  There are other reports talking specifically about Stevia possibly causing palpitations for them.  Truvia does also have some other ingredients, so it isn't clear which of the ingredients is the culprit, if it does in fact cause adverse effects for some people.  
 
 
In March 2022, this person reported in the keto subreddit (there do seem to be a lot of reports of PVCs, rapid heart rate, and palpitations in the Keto subreddit - perhaps I need to look into that possible association as well).  The above linked poster suspects there was an association of palpitations after taking moderate amounts of erythritol, but not small amounts.  They said it took about 3 weeks before symptoms resolved after stopping erythritol.  No one else responded reporting similar issues, so it does not seem to be a common side effect of erythritol.
 
Another post in the keto subreddit, this from 2017, with the person reporting palpitations after starting keto.  Two weeks into starting keto started to have some rapid heart rate (tachycardia).  They took some electrolytes and something they called ketoaide.  They then had three days of bad palpitations and tachycardia.  Bad enough to see a doctor, but did not need the emergency room.  After increasing their carb intake and cutting out electrolyte supplements, their one coffee a day, and increasing vegetable intake, the palpitations and tachycardia resolved. 
 
Some commenters mentioned that when some people are on keto, they become more sensitive to caffeine, experiencing palpitations and increased anxiety when drinking coffee at amounts that did not cause issues previously.  
 
 
One person commented that some people may have undiagnosed fatty acid oxidative (fao) disorder, and they included some links to articles discussing the issue.
 
 
When I searched online for reports of palpitations with Truvia (erythritol, stevia leaf extract, and other natural flavors), I did find a few discussions about people reporting palpitations, and then having them resolve after stopping the food that contained Truvia.  
 
Overall, palpitations are a common experience, and they seem to come and go in most people without clear rhyme or reason.  Fortunately, in almost all cases they are not dangerous - just uncomfortable.  Since sugar substitutes are so common it is easy to try to make an association when it may not actually exist.  I'd love to hear more reports here and see if there is a clearer trend.  The increased reports of irregular heart beats among people doing keto diets is also interesting.  

   
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