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Jul 13, 2023

4 Stevia Side Effects: Weighing Stevia's Pros and Cons

Stevia leaf extract, known to most as stevia, is a natural, zero-calorie

Stevia leaf extract, known to most as stevia, is a natural, zero-calorie sweetener used as a sugar substitute. It is derived from the leaves of the Stevia rebaudiana plant and has been used for centuries in South America.

Though they're rare, stevia's side effects can include gastrointestinal symptoms, decreased blood pressure and blood sugar, and potential impacts on the liver. The Food and Drug Administration (FDA) considers stevia leaf extract safe for consumption, and it is unlikely to cause side effects in most people.

This article discusses the different forms of stevia and the side effects of this sugar alternative.

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Stevia is a zero-calorie sweetener extracted from the Stevia rebaudiana plant. There are 11 steviol glycosides in the stevia leaf, responsible for giving stevia its sweet flavor.

Stevia is available in a few different forms. Some of these are safe for consumption, while others have not been thoroughly evaluated for safety. Forms include:

Stevia is much sweeter than sugar and may be up to 250–300 times sweeter than sucrose, the molecule in table sugar. Despite this, stevia contains no calories or carbohydrates, compared to sugar which has 15 calories and 4 grams of carbohydrates per teaspoon.

Stevia may be a healthy option for those looking to lower their calorie or carbohydrate intake, such as people with type 2 diabetes. However, some studies suggest that consuming nonnutritive sweeteners such as Stevia instead of sugar does not reduce overall calorie intake or blood sugar levels.

Another popular zero-calorie sweetener is sucralose, sold under the brand name Splenda. Sucralose is derived from sugar in a chemical process and is 400–700 times sweeter than sugar. However, animal studies have linked sucralose to cancer and disruptions to the gut microbiome.

Though research on the long-term effects of stevia is limited, there is no evidence that it causes cancer. Sucralose can be especially carcinogenic (cancer-causing) when heated, so stevia may be a healthier option for baking.

Stevia does not cause side effects in most people. However, some may experience the following when consuming products sweetened with stevia:

Early studies of stevia suggested it was linked to cancer, causing the initial FDA ban in 1991. However, subsequent research led the FDA to reverse the ban as hundreds of studies' reviews showed no increased risk of cancer linked to stevia consumption.

Though stevia leaf extract is generally recognized as safe, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) formed the Joint FAO/WHO Expert Committee on Food Additives (JECFA), which has set an acceptable daily intake (ADI) for consumption. The ADI is the maximum average daily intake of a substance over a person's lifetime that is expected to be safe. It is based on significant research.

It is safe to consume stevia every day. However, the ADI for steviol is 4 milligrams (mg) per kilogram body weight per day. This amounts to about 12 mg per kilograms (kg) of Stevia extract per day. For A 150-pound person, this would amount to around 40 packets of stevia.

While that high level of consumption is not generally recommended, it demonstrates the vast volume of stevia you would need to consume for it to be considered unsafe.

Stevia is safe for most people to use. However, since stevia can have blood pressure– and blood glucose–lowering effects, as well as diuretic effects, those taking certain medications or who have certain health conditions should talk with their healthcare provider before consuming significant quantities of Stevia.

People who may be more likely to experience side effects from stevia include people taking medications to lower blood pressure or blood glucose or those diagnosed with:

Stevia leaf extract is safe to consume when pregnant or breastfeeding. However, whole stevia leaf is not approved by the FDA and is not generally recognized as safe for consumption by anyone, especially pregnant people.

Stevia is a zero-calorie, nonnutritive sweetener made from the Stevia rebaudiana plant's leaves. While most people will not experience any side effects from consuming it, stevia blends containing sugar alcohols may cause gastrointestinal symptoms in people with sugar alcohol sensitivity.

Stevia also has blood pressure– and blood glucose–lowering effects, so people on certain medications or conditions should speak with their healthcare provider before using stevia for a prolonged period.

If you are concerned about the potential side effects of stevia, research shows that it is safe to consume and unlikely to cause side effects in most people. It can be hard to know what foods are healthy, with so many options available today, but following a balanced diet and enjoying sugar and other sweeteners in moderation is the best way to keep your body healthy while still enjoying the foods you love.

In 1991, the FDA banned stevia over concerns that it was linked to cancer. However, the FDA reversed the ban in 1995 after a follow-up study found no connection. stevia leaf extract (greater than 95% steviol glycosides) was determined to be generally recognized as safe in 2008 by the FDA.

Stevia is not known to cause inflammation. Some studies suggest it may have anti-inflammatory properties, though more research is needed to determine the magnitude of this effect.

Stevia contains zero calories and carbohydrates, while sugar contains 15 calories and 4 carbohydrates per teaspoon. However, studies suggest that consuming sugar substitutes such as stevia in place of sugar does not have an impact on overall daily calories intake or blood sugar levels.

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By Rebecca Valdez, MS, RDNRebecca Valdez is a registered dietitian nutritionist and nutrition communications consultant, passionate about food justice, equity, and sustainability.