Stevia safety: Forms, dosage, and side effects

Stevia is often touted as a safe and healthy sugar substitute that can sweeten up foods without the negative health effects linked to refined sugar.

It’s also associated with several impressive health benefits, such as reduced calorie intake, blood sugar levels, and risk of cavities.

However, some concerns surround stevia’s safety — especially for certain people who may be more sensitive to its effects.

What is your main goal?

Lose weight

Gain muscles

Eat healthy

Explore new cuisines

This article examines stevia’s safety to help determine whether you should use it.

In this article

What is stevia?

Stevia is a natural sweetener derived from the leaves of the stevia plant (Stevia rebaudiana).

It has zero calories but is 200 times sweeter than table sugar, so it’s a popular choice for many people looking to lose weight and decrease sugar intake.

This sweetener has also been associated with several health benefits, including lower blood sugar and cholesterol levels.

Nevertheless, commercial stevia products vary in quality.

Many varieties on the market are highly refined and combined with other sweeteners — such as erythritol, dextrose, and maltodextrin — which may alter its potential health effects.

Meanwhile, less processed forms may be lacking in safety research.

Forms of stevia

Stevia is available in several varieties, each differing in its processing method and ingredients.

For instance, several popular products are stevia blends, which are one of the most heavily processed forms of stevia.

They’re made using rebaudioside A (Reb A), a refined stevia extract, alongside other sweeteners like maltodextrin and erythritol.

During processing, the leaves are soaked in water and passed through a filter with alcohol to isolate Reb A. Later, the extract is dried, crystallized, and combined with other sweeteners and fillers.

Pure extracts from Reb A are also available as both liquids and powders.

Compared to stevia blends, pure extracts undergo many of the same processing methods — but are not combined with other sweeteners or sugar alcohols.

Meanwhile, green leaf stevia is the least processed form. It’s made from whole stevia leaves that have been dried and ground.

Although the green leaf product is typically considered the purest form, it’s not as thoroughly studied as pure extracts and Reb A. As such, research is lacking on its safety.

Stevia’s safety and dosing

Steviol glycosides, refined extracts of stevia like Reb A, are recognized as safe by the Food and Drug Administration (FDA), meaning they can be used in food products and marketed in the United States.

On the other hand, due to a lack of research, whole-leaf varieties and raw stevia extracts are currently not approved by the FDA for use in food products.

Regulatory agencies like the FDA, the Scientific Committee on Food (SCF), and the European Food Safety Authority (EFSA) define the acceptable daily intake of steviol glycosides as up to 1.8 mg per pound of body weight (4 mg per kg).

Stevia’s safety in certain populations

Although many stevia products are generally considered safe, some research indicates that this zero-calorie sweetener may impact certain people differently.

Due to health conditions or age, various groups may want to be especially mindful of their intake.

Diabetes

You may find stevia helpful if you have diabetes — but be careful about which type to choose.

Some research indicates that stevia may be a safe and effective way to help manage blood sugar levels in people with type 2 diabetes.

One small study in 12 people with this condition showed that consuming this sweetener alongside a meal led to greater decreases in blood sugar levels compared to a control group given an equal amount of corn starch.

Similarly, an 8-week study in rats with diabetes noted that stevia extract decreased blood sugar and hemoglobin A1C levels — a marker of long-term blood sugar control — by over 5% compared to rats fed a control diet.

Certain stevia blends may contain other sweeteners — including dextrose and maltodextrin — that can increase blood sugar levels.

Using these products in moderation or pure stevia extract can help maintain normal blood sugar levels if you have diabetes.

Pregnancy

Limited evidence exists on the safety of stevia during pregnancy.

However, animal studies suggest that this sweetener — steviol glycosides like Reb A — does not negatively impact fertility or pregnancy outcomes when used in moderation.

Additionally, various regulatory agencies consider steviol glycosides safe for adults, including during pregnancy.

Still, research on whole-leaf stevia and raw extracts is limited.

Therefore, it’s best to stick to FDA-approved products containing steviol glycosides rather than whole-leaf or raw products during pregnancy.

Children

Stevia can help reduce added sugar consumption, which could be especially beneficial for children.

According to the American Heart Association (AHA), a higher added sugar intake could increase children’s risk of heart disease by altering triglyceride and cholesterol levels and contributing to weight gain.

Swapping added sugar for stevia could potentially minimize these risks.

The FDA has approved steviol glycosides like Reb A. However, it’s especially important to monitor intake in kids.

This is because it’s much easier for kids to reach the acceptable daily limit for stevia, which is 1.8 mg per pound of body weight (4 mg per kg) for adults and children.

Limiting your kid’s consumption of foods with stevia and other sweeteners, such as sugar, can help prevent adverse side effects and support overall health.

Summary: Steviol glycosides like Reb A are approved by the FDA — while whole-leaf and raw extracts are not. Stevia may impact certain groups differently, including children, pregnant women, and people with diabetes.

Side effects of stevia

Although generally recognized as safe, stevia may cause adverse effects in some people.

For example, one review noted that zero-calorie sweeteners like stevia could interfere with concentrations of beneficial gut bacteria, which play a central role in disease prevention, digestion, and immunity.

Another study of 893 people found that variations in gut bacteria could negatively impact body weight, triglycerides, and HDL (good) cholesterol levels — known risk factors for heart disease.

Some research even suggests that stevia and other zero-calorie sweeteners could lead you to consume more calories throughout the day.

For instance, one study of 30 men determined that drinking a stevia-sweetened beverage caused participants to eat more later in the day than drinking a sugar-sweetened beverage.

Moreover, a review of seven studies discovered that routine consumption of zero-calorie sweeteners like stevia may contribute to increased body weight and waist circumference over time.

Additionally, certain products with stevia may harbor sugar alcohols like sorbitol and xylitol, which are sweeteners sometimes associated with digestive issues in sensitive individuals.

Stevia may also reduce blood pressure and blood sugar levels, potentially interfering with medications used to treat these conditions.

For best results, moderate your intake and consider reducing consumption if you experience any negative side effects.

Summary: Stevia may disrupt your levels of healthy gut bacteria. Counterintuitively, some evidence suggests that it could increase food intake and increase body weight over time.