Is Stevia Better or Worse for You Than Other Sweeteners?

There are many options for sweetening your food and drinks if you’re trying to avoid regular table sugar. And these different types of sweeteners are becoming more popular. If you’re looking for a natural, no-calorie sweetener, stevia might be a good option for you. Here, we compare stevia to table sugar and other common sweeteners, and discuss its potential health risks and benefits.

What is stevia?

Stevia is a natural sweetener that comes from a plant called Stevia rebaudiana. It’s a member of the sunflower (Asteraceae) family. 

The term “stevia” may be used to describe the sweetener in a few different forms. This can be confusing because there’s some overlap in the terminology. Here are some common forms of stevia and what each is made of:

• High-purity stevia leaf extract: This is what you’ll find sold in grocery stores. This is also the only form of stevia used in processed foods and drinks. High-purity stevia leaf extract contains 95% or greater steviol glycosides, the natural compounds present in the plant’s leaf. 

• Whole plant or “raw” stevia: This is also known as Stevia rebaudiana Bertoni. This form of stevia isn’t approved for use in the U.S., as it hasn’t been adequately tested for safety.  

• Stevia extract: This is made from steeping the leaves of the plant in water to extract the sweet compounds into the liquid. 

For the purposes of this article, the word “stevia” refers to high-purity stevia leaf extract. This is the version of stevia that most people are familiar with.

Is stevia safe?

Pure stevia is a safe food product. Consuming it in moderation doesn’t pose significant health risks. The FDA categorizes stevia as “generally recognized as safe” (GRAS). But sometimes stevia is combined with other additives or sugar alcohols to increase its bulk and sweetness. Those ingredients can come with some associated risks.

What are the risks and side effects of consuming stevia?

Consuming pure stevia in moderation is unlikely to cause side effects. But when stevia products contain other additives and sweeteners, they can cause health effects, including:

• Increase in blood sugar levels: Pure stevia has a glycemic index of near 0. This means that it has little to no effect on your blood sugar level. But if stevia is combined with additives like maltodextrin and dextrose, it can raise a person’s blood sugar. This is especially important for people with health conditions like diabetes.

• Increased risk of heart attack and stroke: Sometimes stevia is combined with erythritol, a sugar alcohol that’s been linked to an increase in heart attack and stroke. 

• Digestive issues: Sometimes stevia contains sugar alcohols like xylitol. These sugar alcohols can cause upset stomach and diarrhea.

This is why it’s important to check the package before assuming you’re consuming pure stevia.  Note that some studies suggest that even pure stevia may have an impact on the healthy bacteria naturally found in a person’s gut.

Does stevia have any health benefits?

More research is needed to understand stevia’s long-term effects. But some research suggests that stevia may have potential health benefits. 

Insulin and blood sugar levels 

In a study of people with diabetes, drinking tea sweetened with stevia didn’t raise blood sugar levels. It also didn’t change hemoglobin A1C, a measure of your average blood glucose level over 3 months. So, stevia may be a good sugar substitute for people trying to manage their blood sugar.

EXPERT PICKS: WHAT TO READ NEXT

• Is natural sugar better than refined sugar? Yes, because natural sugar is found in foods that also deliver important nutrients. But it’s important to try and limit all sugar intake. 

• The best natural sweeteners: The best one for you depends on your health, taste preferences, and how you plan to use it. Some, like honey and molasses, even have health benefits.

• Do artificial sweeteners cause cancer? No. Here, we review the research on aspartame, saccharine, and other artificial sweeteners.

• How to cut back on sugar: Small, gradual diet adjustments can help you reduce your sugar intake. Instead of doing a strict “detox,” it’s best to find a long-term, sustainable approach.

Blood pressure 

Stevia may have benefits for blood pressure. In one study, people who took 500 mg of stevia powder daily for 2 years saw a decrease in blood pressure. Systolic blood pressure levels (the top number) decreased by about 10 mmHg. Diastolic blood pressure (the bottom number), decreased about 6 mmHg. But a larger review of several studies saw a small decrease in diastolic levels only. 

Cancer 

For a long time, many people thought that artificial sweeteners were linked to cancer — but this hasn’t included stevia. (And several studies have since shown that there may not actually be a link between artificial sweeteners and cancer.) 

When it comes to stevia, test tube and animal studies suggest that stevia may actually inhibit the growth of cancer cells. But without further studies, it’s too early to tell if this is true in humans.

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Kidney health 

In a study of people with early-stage chronic kidney disease (CKD), participants took 250 mg of stevia daily. After 3 months, their blood markers reflected improved kidney function. To date, there are no other human studies on stevia and kidney function.

Metabolic dysfunction-associated steatotic liver disease (MASLD)

Stevia may help prevent metabolic dysfunction-associated steatotic liver disease or MASLD (formerly called “nonalcoholic fatty liver disease,” or NAFLD). But all of the research to date has been done in animals. So, it’s too early to know if this benefit applies to humans.

How does stevia compare to sugar?

Stevia tastes up to 400 times sweeter than standard table sugar. But it may be better for your health. Eating more than the recommended amount of refined sugar has been linked to serious health conditions, including: 

• Obesity

• Type 2 diabetes 

• High blood pressure

• High cholesterol

• Heart disease 

How does stevia compare to artificial sweeteners?

You may be wondering how stevia compares to artificial sweeteners, which also have very few calories. Common artificial sweeteners include:

• Aspartame, often sold as the brand Equal  

• Saccharin, sold as Sweet’N Low

• Sucralose, which you may know better as Splenda

The key difference between stevia and these other sweeteners is that stevia is a natural sweetener. It comes from a plant. Artificial sweeteners, on the other hand, are all made by modifying the sugar molecule in a lab. 

The following table highlights some of the key differences between stevia and artificial sweeteners.

It’s still unclear how artificial sweeteners affect long-term health. But so far, stevia appears to be safer. 

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Written by:

Cherilyn Davis, MD

Cherilyn Davis, MD, is a board-certified pediatrician in NYC. She's held local and national roles at the American Medical Women's Association, including board member of the physician division and physician chair of social media.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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