By Courtney Sperlazza, MPH
Medically reviewed by Dr. James DiNicolantonio and Dr. Anthony Gustin.
While stevia is becoming more widely accepted as an everyday sweetener, it still gets mixed reviews. Stevia is a plant-derived sugar substitute that is intensely sweet with a neutral flavor. It does not appear to impact blood sugar levels, which makes it a go-to choice for people who are watching their sugar and carbs.
Still, you may have questions. Is it safe to use frequently? Does it contain chemicals you’d rather avoid? Does it mess with your gut health or hormones? In this article, we will dig into some of the more common questions about stevia so that you can decide whether it fits into your health regimen.
What Is Stevia?
Stevia is a natural sweetener derived from the leaves of the Stevia rebaudiana plant, native to Paraguay. Stevia has been used for centuries as a sweetening ingredient, and it has gained popularity as a sugar substitute due to its intense sweetness without adding calories or carbohydrates.
The sweetness in stevia comes from a group of natural compounds called steviol glycosides, the most common of which is called stevioside. Steviol glycosides are extracted from the leaves of the stevia plant, and then they are processed and purified to obtain a concentrated form of stevia sweetener.
Stevia is used in a variety of food and beverage products, including sodas, bar mixers, baked goods, sugar-free candies, and as a general-use sweetener. It is available in different forms, such as powder, liquid, and granules, and is considered safe for consumption by regulatory agencies in the US, Europe, and other regions.
Stevia is also known for its sweetness intensity, as it is estimated to be 200-350 times sweeter than sucrose (table sugar) in its purified form. That means that only a tiny amount is needed to achieve the desired level of sweetness.
As with any food ingredient, it is important to use stevia in moderation as part of a balanced diet.
Types of Stevia
There are around 40 different steviol glycosides derived from the stevia plant. In the U.S., certain steviol glycosides are approved for use as sweeteners in foods and beverages. The most commonly used approved steviol glycosides are:
- Stevioside: This is the most abundant and commonly used steviol glycoside. Stevioside is extracted from leaves of the stevia plant and forms a white powder which is easily added to foods. The final extract contains stevioside and the rebaudiosides.[*] Some people report a bitter aftertaste or a licorice flavor when they consume products containing stevioside..
- Rebaudioside A (rebA): This steviol glycoside is often used in low-calorie and sugar-free food and beverage products because it is much sweeter than stevioside, so less product is needed for a sweet taste. Additionally, people tend to notice less of an aftertaste with rebA. Equip products contain 100 mg of pure rebA without sweetener additives like erythritol.
- Rebaudioside D (rebD): This steviol glycoside is another less bitter sweetener option that is approved for use in foods in the U.S.
- Rebaudioside M (rebM): This steviol glycoside is also less commonly used in food and beverage products but has been approved for use in foods in the U.S. Manufacturers use it because it doesn’t have the bitterness that stevioside has.
Is stevia bad for you?
As a natural sweetener, stevia is generally considered safe for most people if consumed in amounts typically used to sweeten foods. It has been approved for use as a food additive by regulatory agencies in the United States and has undergone extensive safety evaluations.[*]
However, it's worth noting that some individuals may have individual sensitivities or allergies to stevia or its components, and may experience reactions. Some people experience side effects of stevia, including gastrointestinal symptoms such as bloating, gas, and diarrhea.
Additionally, some people may not love the aftertaste, which can affect their overall preference for the sweetener. Most of the time, when used in reasonable amounts, side effects and aftertaste aren’t issues.
It’s important to note that stevia products may contain other added ingredients or fillers, so it's important to read ingredient labels to ensure the purity and quality of the stevia product.
Stevia, Blood Sugar and Insulin
As with most sweetener options, many people wonder whether stevia raises blood sugar or spikes insulin.
The short answer is no, stevia is not known to raise blood sugar levels.[*] One of the reasons why stevia is such a popular sugar substitute is because it does not add to calories or carbohydrates and does not contribute to increased blood sugar.
Stevia's sweetness comes from steviol glycosides, a group of natural compounds found in the leaves of the stevia plant, which are not metabolized by the body and do not impact blood sugar levels.
Research on stevia has shown its potential to reduce blood sugar levels.[*] One study showed that it reduced blood sugar in diabetic rats.[*] Another study[*] found that stevia is a safe sweetener for diabetics and could have a therapeutic effect, but a much higher dose would be needed than you would use to sweeten foods and beverages.
The amount in Equip foods isn’t anywhere near a therapeutic dose. We add just enough to get the taste just right.
More research is needed to fully understand stevia's effects on blood sugar and its long-term health implications. Work with a qualified medical professional if you want to lower your blood sugar, especially if you have diabetes.
How Stevia Is Made
First, the food-grade stevia leaves are dried, then steeped in hot water. (Think: giant cup of tea.) The “tea” is then purified with several rounds of filtration and centrifuging—which is spinning the liquid to separate the water from the good stuff.
The purified “tea” is then strained through a porous material that captures the steviol glycosides (the sweet compounds) and washes the rest away. The remaining steviol glycosides are mixed with alcohol to help loosen them from the porous material and send them to the next vessel.
Then, the alcohol is removed first by filtration, then by distillation, which leaves behind a steviol glycoside syrup. This syrup is sent through carbon filters, much like we use to filter water, to get rid of the yellowish hue, and it is filtered again just in case there are unwanted particles left.
Last step: the syrup is sprayed into a tank with hot air, which evaporates the fluid and leaves pure crystals behind.
There’s a common misconception that stevia is extracted using chemicals, but the harshest substance it comes into contact with is alcohol, and that is eleminated about halfway through the process.
Is stevia an artificial sweetener?
Since stevia sweetener comes from a plant, it is not an artificial or chemical sweetener.
The terms ”sugar substitute” and “artificial sweetener” are often used interchangeably, but they aren’t the same thing.
Artificial sweeteners, or chemical sweeteners, are synthetic additives. You may be familiar with some of the more common artificial sweeteners, including:
- Saccharin
- Acesulfame potassium
- Sucralose
- Aspartame
Not all sugar substitutes come from a laboratory. Natural sweeteners are found in nature, and include:
- Stevia
- Erythritol
- Xylitol
- Monk fruit
- Sugar alcohols
Sweet ingredients like honey, molasses, maple syrup, coconut sugar, and date sugar could be considered natural sweeteners. But, since these sweeteners do have calories and impact blood sugar, they aren’t always lumped into the same category.
Does stevia cause cancer?
Currently, there is no scientific evidence that indicates a relationship between stevia and cancer in humans. Several studies have been conducted to investigate the safety of stevia, including its potential carcinogenic effects, and the overall body of evidence suggests that stevia is safe when consumed in amounts typically used to sweeten foods.
Note that some stevia products on the market may contain additional additives that could alter the product’s overall safety. Equip products are sweetened with only pure stevia rebA and no additional sweetener ingredients.
As with any food or food ingredient, it is always a good idea to carefully read labels, follow recommended usage guidelines, and consult with a healthcare professional or a registered dietitian for personalized advice.
Stevia and Your Microbiome
Some studies suggest that stevia may have antimicrobial properties, which begs the question: could stevia negatively affect the composition and diversity of your gut microbiome?
Before we get into it, it’s worth noting that every time you eat, you alter your microbiome. Certain strains like certain foods and flourish, while others may pull back depending on what you’re eating.
Stevia isn’t the only plant with antimicrobial activity. Rosemary, basil, sage, oregano, garlic, thyme, clove, and so many others can all pose a threat to bacteria, fungi, and viruses (depending on dose, strain, etc.), and the list doesn’t stop there.
If you decide to avoid plants with antimicrobial activity, you’ll end up eliminating a lot of foods and all of the nutrients, antioxidants, and fiber that come with them. While one plant may knock out one type of bacteria, it may help hundreds of others flourish.
What does the research say so far?
There are studies that show that stevia may negatively affect microbial colonies in the digestive tract.[*] The available research doesn’t perfectly answer the question though, as studies are often conducted on animal models, and there may be other factors in play—for example, in one study, researchers induced obesity which could affect the overall result.[*]
There are also studies that show that stevia may have a beneficial effect on the microbiome.[*][*] One study comparing several sweeteners and additives demonstrated that while many of the additives reduced microbiota diversity, stevia seemed to induce a higher diversity measure.[*]
To support your gut, focus on eating a varied diet with a wide array of nutrients that your gut loves, like resistant starch. Also, avoid known gut disruptors, like alcohol, smoking, overuse of medications, stress, etc.
Is stevia keto?
Stevia is a keto sweetener option. The amount of stevia you would use to sweeten foods and beverages contains no carbohydrates.
Is there erythritol in stevia?
Because one drop of stevia is so powerfully sweet on its own, companies sometimes add erythritol to add volume and make stevia easier to use. Check package labels if you want to know what you’re getting. Equip's stevia is pure stevia and nothing else!
Is stevia safe during pregnancy?
In the US, stevia is considered to be safe to use during pregnancy. It has been given the GRAS (generally recognized as safe) designation by regulatory agencies. If you are pregnant or nursing, always check with your doctor before making any changes to your health regimen.
Equip products are sweetened with 100 mg of pure stevia rebA without additives like erythritol.
Stevia and Endocrine Disruption
Stevia’s effect on hormones has been a hot topic of discussion ever since stevia products came back on the market in the early 2000s. Are concerns warranted? Let’s look at the research.
One lab study found that sperm cells exposed to stevia produced more progesterone, suggesting that stevia may affect the endocrine system.[*] While this is worth paying attention to, we cannot assume the same for the interaction between sperm and stevia in a real-life setting.
This was done in vitro, which means in a laboratory (as opposed to in vivo, in a living organism), and sperm are unlikely to experience exposure to that amount of stevia when consumed.
Stevia and Fertility
A paper from the 1960s said that a native group in Paraguay used stevia as a contraceptive, so a doctor tested this in rats. He found that the rats did not conceive during consumption of the stevia decoction and also for up to 60 days after.[*]
The rats were given an extremely high dose, though, which you’re not likely to replicate if you’re using stevia to sweeten your foods and drinks. Equip products contain a standard 100 mg of pure stevia rebA, which is considered to be a very low dose—just enough to sweeten foods. If you’re trying to conceive, ask your doctor to be sure.
As far as stevia’s effect on hormones go, research is extremely limited, there aren’t conclusive human studies, and there’s nothing reliable anecdotally that points to stevia causing hormone issues or infertility.
Check with your doctor or dietician to be sure, and if you’ve been consuming stevia, you can always have your hormones tested to make sure everything is in working order.
Final Thoughts
Stevia is a naturally-derived, zero-calorie sweetener that people are turning to as a healthier alternative to traditional sugar. Its sweetness comes from the compounds found in the leaves of the stevia plant, and it has been used for centuries as a sweetening agent in various parts of the world. Stevia has been extensively researched and has been found to be safe for consumption, with no known adverse effects on health. While there are some concerns about potential chemical processing and its effect on your microbiome or your hormones, there is no conclusive evidence that it is harmful. Stevia offers a viable option for those looking to reduce their sugar intake, manage their weight, or help manage health conditions such as diabetes. Stevia provides a promising alternative to conventional sweeteners for those looking to enjoy sweet foods without the aftereffects of sugar.
