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Stevia Is *Not* a Good Sweetener for an Autoimmune Diet

I strive to be discerning and unbiased in my work as a Nutritionist, and as an integrative practitioner, I feel that it is paramount to remain open to new perspectives.  This doesn’t change the fact that I feel horrible when I realize that I’ve been giving the wrong advice, or that I’ve allowed a potentially harmful product to slip under my radar.

Such is the case with stevia.

I have been anti-artificial sweeteners for many years, where many of my conventional counterparts have welcomed them with open arms.  When Truvia came along, I was quick to point out that it was highly processed and contained questionable additives.  I recommended having 100% pure stevia in small amounts and limiting the frequency.  Not terrible advice, really, but for a Nutritionist who has been on the glycemic regulation band-wagon for quite some time, I might have connected the dots a little sooner.

We’ve known for quite some time, since the late 80’s, in fact, that non-nutritive sweeteners increase food intake.  Why didn’t I equate this with blood sugar dysregulation?  Blood sugar control for weight management and decreasing inflammation are key to the foundation of my philosophy on optimal nutrition and wellness, especially for those dealing with autoimmune diseases.

Here’s the problem with stevia concerning blood sugar dysregulation—as a non-nutritive sweetener, stevia does not contain any sugars or calories, but it does impart the sweet taste to the taste buds.

When the brain senses the sweet taste, signaling processes clear the blood stream of sugars in order to make way for more sugars.  Now, this would be fine if there were actually more sugars (not too many, though) coming down the pike; however, since there are none, this leaves the blood sugar tanked and thus, results in hypoglycemia.

Hypoglycemia, in turn, leads to an effort by the body to replenish blood sugar levels by calling upon stored glucose from the liver and muscles, in the form of glycogen.  To accomplish this mobilization of glucose from body stores, stress hormones must be released.

When hypoglycemia becomes a pattern, it leads to excessive appetite (especially for carbohydrates) and belly fat deposition (which is an indicator of inflammation and estrogen dominance) from the regular and excessive release of stress hormones.

For anyone with an autoimmune disease, I would now caution the use of stevia, especially in conjunction with a low or carbohydrate-free meal or snack.  Hypoglycemia most often leads to hyperglycemia (i.e., the blood sugar rollercoaster), due to over-eating carbohydrates as an effort to correct, albeit over-correct, low blood sugar levels. This pattern is a recipe for increased inflammation.

That said, even those without autoimmunity should use stevia and other non-nutritive sweeteners sparingly, if at all, just as they should use added sugars.  In my opinion, sticking to real sugars in moderation is the way to go.

Safe added sugars to use in moderation include sugars from whole fruits, raw honey, maple syrup and coconut palm sugar.  If and when you do consume stevia, it would be best to consume it as a part of a mixed meal or snack, meaning that what you are eating contains a balance of complex carbohydrates, protein and fat.  This will offset stevia’s potential hypoglycemic effect.

The other issue, which I’ve already alluded to, is hormonal imbalance.  Our hormones exist in a delicate dance with one another.  When one hormone is out of balance, they can all become imbalanced.  Many people with autoimmunity struggle with hormonal imbalances, such as with stress, insulin, thyroid and sex hormones.

Hormonal imbalances are tightly linked to blood sugar control, and simply stepping off of the blood sugar roller coaster to normalize insulin and stress hormones can be a major factor in restoring hormonal balance and therefore, to feeling better.

So, as paradoxical as it may seem at first glance, regularly consuming non-nutritive sweeteners—even natural versions like pure stevia—is not a good strategy for maintaining optimal blood sugar, hormone and inflammatory responses, particularly when consuming a low-or no-carbohydrate diet, which I actually do not recommend for sustained periods of time in most people.  We do need carbohydrates to function optimally—we just need to avoid over-consumption and choose the right ones.

According to Sarah Ballantyne, PhD, and author of The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body, there is also evidence that aside from the hormone-altering effects of hypoglycemia induction, stevia itself may impact estrogen and progesterone levels.

She states that steviol glycocides, which are responsible for the sweet taste of stevia, actually have a hormone structure.  In Chapter 3 of her book, she points to studies that have shown contraceptive effects of stevia in rats, and notes that although there have been no human trials, the stevia plant was traditionally used as a female contraceptive by the Guarani Indians in the south of Brazil.

She maintains that, “For those with autoimmune disease, in which hormones have such a dramatic impact on disease development and progression, the impact of consuming stevia on hormone regulation is relevant… While small and occasional consumption of stevia likely has little to no impact on general health, it should not be consumed on a regular basis especially by those with altered hormone balance and dysfunctional immune systems.”

One last issue in my mind is that by using non-nutritive sweeteners, one is not paying attention to breaking the addiction to the sweet flavor, but instead perpetuating it, since non-nutritive sweeteners are considerably sweeter than sucrose and other saccharides.

Additionally, upon substituting non-nutritive sweeteners for sugars, one will likely continue to under-appreciate and under-consume the other flavors—sour, pungent, bitter and astringent.  Traditional Chinese Medicine, as well as the ancient science of Ayurveda, would have us consume a balance of all of the flavors for optimal health.

In Western terms, we know that consuming a variety of foods, especially plant foods, ensures a balanced intake of nutrients and antioxidants.  Furthermore, if we over-appreciate sweet and under-appreciate bitter, we are missing out on some of the most highly anti-inflammatory compounds that the diet can offer.

For optimal health and management of autoimmunity, my best advice to my fellow Autoimmune Moms regarding sweeteners, is to steer clear of or minimize the use of the non-nutritive ones, including pure stevia.  If and when you do consume stevia, make sure it is 100% pure and to only have a very small amount as a part of a balanced meal or snack.


About the Author
Angie King-Nosseir MS, RD is an Integrative and Functional Registered Dietitian, with a passion for walking with people along their path toward health transformation. Angie has a Master’s degree in Nutrition, is a Certified LEAP Therapist, corporate wellness health coach, freelance nutrition and wellness writer, and certified yoga instructor. She is trained in Functional Nutrition and Medicine through the Institute for Functional Medicine and in Food as Medicine through the Center for Mind-Body Medicine.

This blog post was originally published by AutoimmuneMom.com, written by Angie King-Nosseir, and first published on Oct 26, 2014.

This post contains the opinions of the author. AARDA is not a medical practice and does not provide medical advice, diagnosis, or treatment. It is your responsibility to seek diagnosis, treatment, and advice from qualified providers based on your condition and particular circumstances. AARDA does not endorse nor recommend any products, practices, treatment methods, tests, physicians, service providers, procedures, clinical trials, opinions or information available on this website. Your use of the website is subject to our Privacy Policy.


  1. davet says:

    I never rely on, or even read, any advice given by “nutritionists”, “naturopaths” “chiropractors” and the like because they do not provide references to the scientific studies, if any, that they base their advice on. When I did read their material in the past, I often found frank errors, misinterpretations, but mostly out-of-date and questionable sources, or no sources whatsoever (please point me to the body of peer reviewed scientific studies that prove that we should be drinking 8 glasses of water a day. Or simply point me to one such study. No such thing exists. There is no such proven requirement, yet nutritionists et al have spread this myth far and wide.) This is one of the less harmful recommendations. If you want your professions to be taken seriously, then your professions must establish professional standards of practice, and such standards should include the requirement that supporting studies, or at least access to supporting studies accompany all your public pronouncements, and your professional practice.
    My advice to fellow autoimmune persons is to stick to the science (including well-established eastern medicine that has been tested over thousands of years). Don’t trust your MD either. Some are relying on shockingly out of date studies, and are totally unaware of emerging science). Find the best you can, someone referred to you by a current or former patient (there are a growing number of websites giving ratings to doctors). Then familiarize yourself with PubMed and what it has to offer. Also, for supplements, don’t take ANYTHING until you checked with ConsumerLab.com, or a similar service (I believe some of the medical centers of excellence are now offering a similar service for free, ConsumerLab.com is pretty cheap, I believe about $39 per year (I am not affiliated with them in any way)–save yourself a serious mistake by using these resources to find out which supplements are supported by science, and which supplements are actually harmful (for example “seaweed” or any form of supplemental iodine for Hashimotos–iodine overload is the CAUSE of many cases of Hashimotos. Also, for the same reason, avoid iodized salt, in the USA we are already getting too much iodine in our diet without using iodized salt. In countries that have introduced and mandated iodized salt to reduce hypothyroidism, they found that the incidence of Hashimotos tripled or quadrupled with the mandate of iodized salt. You can find this info on PubMed. YOU HAVE TO BE YOUR OWN ADVOCATE. Also, in my case, I was blessed with a Primary Care Doc who does not practice “robotic” medicine, and is experienced enough and confident enough to apply his common sense, as well as what the specialists recommend, to any problem. Find one of these docs, and stick with them. Finally, I want to add that there are a few, rare chiropractors who are competent, and you find these by asking around, by doing some detective work. I’m sad to say the truth based on my own extensive experience: the majority of chiropractors are phonies, and a large minority are borderline-criminals, insurance cheats, and somewhat sociopathic. BE CAREFUL, because many are quite charming and solicitous, as most sociopaths are. This is my opinion based on my own personal experience, and that of my family. I would love to be proven wrong, because I believe most people are doing the best they can, and even incompetent chiropractors may believe they are doing the right thing. My message to the legitimate chiropractic community operating within their areas of competency supported by science and/or legitimate ayurvedic/chinese medicine, is that you need to police and weed-out your own profession. It is presently a disgrace in my direct experience.

  2. Tim Sanders says:

    Amen Davet!! I often comment on blogs “show me the studies”. I often get the response “well we have no money to form peer reviewed or implemented studies because we are not an accepted part of the medical establishment”. Yet the “natural” vitamin and supplement industry is a multi billion dollar industry. One would logically think that industry could establish several research entities, independent of one another, that could do research on the claims of beneficial or harmful effects of any vitamin and/or supplement that is labeled “natural” or not. The origin of that vitamin or supplement, natural vs. synthetic, would be most helpful in determining my own choice of whether to buy it or not. Without such research projects, the “natural” branding by these multitude of companies selling their questionable products is just plain “Scam Marketing” and should be recognized as such. The problem with all things marketable in this day and age is “the spin factor”, as I call it. One day we are told through the media that salt with iodine is bad for us, so many have switched to natural sea salt (with too little iodine). Then we are told that Americans are becoming iodine deficient and yet another pill is marketed to correct that “condition”. There are many other substances that have been rotationally marketed or taken off the market in what I see as a carefully implemented “marketing cycle” by those who control media release of this information. I call them the marketing cartels. Thank YOU for bringing this to the forefront of discussion and I hope you can get this out to more and more people and organizations that disseminate all this marketing hype and those that suffer from it.


    Tim Sanders
    Reno, Nv.

    • Dominique Beakison says:

      Agreed, but For what it’s worth, she referenced
      Sarah Ballantyne, PhD, and author of ‘The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body’ which most likely supplies the sources for a chunk of those claims. I’m not familiar with the book or the author.

  3. catherine ritlaw says:

    Have used stevia for almost 20 years. I have chronic Lyme (44 years), 6 autoimmune diseases. Immune system over- activated, kills too much Lyme & I get more toxic. Every day is a challenge. I just discovered stevia is an immune modulator & also kills Lyme & especially the spore form of Lyme. Exactly what I don’t need! Stopped a few days ago and am starting to improve.

  4. Donna says:

    What about monk fruit extract?

  5. Susan says:

    this info is what I was looking for. I have autoimmune and was about healed thru diet. My symptoms have returned and I’ve been researching to find out why…what have I been eating? The only thing newly added to my diet was good earth tea. Didn’t think to look at the label for whatever reason. Today I did and was horrified to see stevia listed. After reading this article, I believe I have found the culprit. Stevia

  6. KELLY says:


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