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What is sorbitol?
Sorbitol, also called D-sorbitol, 50-70-4, E420, and D-glucitol, is a type of carbohydrate. It falls into a category of sugar alcohols called polyols.
This water-soluble compound is found naturally in some fruits, including apples, apricots, dates, berries, peaches, plums, and figs.
It’s also commercially manufactured from corn syrup for packaged foods, beverages, and medications.
Commercially, sorbitol is used to preserve moisture, add sweetness, provide texture to products, and potentially support digestive and oral health.
Benefits and uses of sorbitol
Sorbitol is a widely used sugar alcohol for several reasons.
First, sugar alcohols are often used in foods and beverages instead of traditional sugar to reduce calorie content. Sorbitol contains approximately two-thirds of the calories of table sugar and provides about 60% of the sweetness.
It’s also not fully digested in your small intestine. What remains of the compound from there moves into the large intestine, where it’s instead fermented, or broken down by bacteria, resulting in fewer calories being absorbed.
Second, the sweetener is often added to foods marketed to people with diabetes. That’s because it has little effect on blood sugar levels when eaten, compared with foods made with traditional sweeteners like table sugar.
Third, unlike table sugar, sugar alcohols like sorbitol don’t contribute to the formation of cavities. This is one reason they’re often used to sweeten sugar-free chewing gum and liquid medications.
The Food and Drug Administration (FDA) has recognized that sugar alcohols like sorbitol may benefit oral health. This is based on a study that found that sorbitol may reduce cavity risk compared with table sugar, although not to the same extent as other sugar alcohols.
Lastly, it’s used as a laxative to combat constipation. It’s hyperosmotic, drawing water from surrounding tissues into the colon to promote bowel movements. It can be purchased at most grocery and drug stores without a prescription.
Side effects and precautions of sorbitol
Consuming sorbitol or other sugar alcohols in large amounts can cause bloating and diarrhea in some people, especially if you’re not used to regularly consuming them. This can be an unwelcome result for some, but the desired effect for those using it to promote bowel activity.
Fortunately, other side effects from sorbitol appear to be uncommon. The most frequently reported complaint is diarrhea, though it may be accompanied by abdominal cramping or nausea.
Still, while some laxatives can be habit-forming and shouldn’t be used for prolonged periods, sorbitol is considered a less risky, non-stimulative laxative. That said, given that it works by drawing fluid into your intestines to promote bowel activity, it should only be used as directed.
Despite its potential side effects, sorbitol has been reviewed and recognized as safe to consume by many global health authorities, including the FDA, Joint FAO/WHO Expert Committee on Food Additives (JECFA), and European Union.
Dosage and how to take sorbitol
Sorbitol for laxative use can be found as a rectal enema or as a liquid solution to be taken orally. You can take it orally with a glass of water or mixed into flavored beverages, with or without food.
Recommended dosages vary. Some studies indicate unwanted side effects are more likely if you consume 10 grams daily. One study found that malabsorption was more likely with doses of 10 grams — even among healthy individuals.
The FDA requires that labels on foods that could cause you to consume more than 50 grams daily include the warning: “Excess consumption may have a laxative effect”.
Taking too much sorbitol can cause severe digestive side effects and electrolyte imbalances, although there’s no evidence that the compound can cause toxicity.
Suggested read: 20 foods and drinks that help with bloating
Contact your healthcare provider immediately if you’ve taken too much sorbitol and are experiencing significant symptoms. Be prepared to provide information about the dosage and your symptoms, including the timing of their onset.
Ultimately, it’s best to follow consumer directions on the packaging. Alternatively, consult your healthcare provider for questions about appropriate dosing and usage.
Interactions
Sorbitol should not be taken with calcium or sodium polystyrene sulfonate, which are used to treat high levels of potassium in the blood. Doing so can cause an interaction that leads to intestinal tissue death.
If you’re taking sorbitol to alleviate constipation, avoid using other laxatives simultaneously unless your healthcare provider specifically directs you.
Storage and handling of sorbitol
Most sorbitol can be stored at room temperature, or approximately 77°F (25°C). It should not be frozen or kept in hot environments, as this may reduce its shelf life.
However, many variations of sorbitol products exist, so it’s likely that their shelf lives vary.
If stored correctly, most products typically last 6–12 months, although this depends on the form and brand. Once a product expires, discard it appropriately through a drug take-back event or another safe disposal method.
Pregnancy and breastfeeding
While clinical research on the effects of taking sorbitol while pregnant or breastfeeding is limited, sugar alcohols and polyols are generally considered safe to use in moderation.
Yet, as with other medications and supplements, it’s always a good idea to speak with your healthcare provider before using sorbitol if you’re pregnant or breastfeeding.
Use in specific populations
When used correctly, Sorbitol is generally considered a low-risk laxative for most people, although certain populations should avoid it.
Caution is advised if using sorbitol for children. It’s best to speak to your healthcare provider for specific dosing for kids.
Suggested read: What are sugar alcohols, and are they a healthy sugar swap?
People with preexisting digestive conditions or sensitivities may also want to avoid the compound.
This includes those following a low FODMAP diet, excluding certain carbs. FODMAP is an acronym for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols,” and sorbitol is a polyol.
The low FODMAP diet is commonly followed by people with irritable bowel syndrome (IBS). As such, those with this condition should avoid using sorbitol.
As with other medications, it’s best to speak with your healthcare provider about the appropriate use and dosage of sorbitol, especially if you have a chronic health condition.
Sorbitol alternatives
Several low-risk options are available if you’re looking for an alternative to sorbitol to provide laxative effects.
The most similar alternatives are other sugar alcohols like erythritol or xylitol, commonly used in chewing gum and diet drinks.
Other foods that may provide similar laxative effects include:
- Flax and chia seeds. These contain 8–10 grams of stool-promoting fiber per 1/4 cup or 3 tablespoons (30 grams), respectively.
- Kefir. This is a fermented milk product rich in probiotics that can increase regularity and the speed of intestinal transit, add moisture, and bulk up your stool.
- Castor oil. This long-used natural laxative is derived from castor beans, which are full of intestinal-movement-promoting ricinoleic acid.
- Fruits and veggies. High-fiber fruits and veggies like berries and leafy greens can boost stool output.
- Legumes. Beans, chickpeas, lentils, peas, and peanuts are rich in fiber and the compound butyric acid, both promoting regularity.
- Prunes and apples. These are natural sources of sorbitol. They may not be good options for those following a low FODMAP diet.
- Senna. This herb is derived from Senna alexandrina and is found in many common over-the-counter laxatives.
- Aloe vera. Aloe vera latex is often used as a laxative. It contains anthraquinone glycoside, compounds that draw water into the intestines and stimulate your digestive tract.
- Magnesium citrate. This common laxative and nutritional supplement promotes bowel movements.
- Coffee. This beverage is a natural bowel stimulant that triggers intestinal muscle movement in many people.
- Psyllium husk. This rich source of soluble fiber can help soften stool and make it easier to pass.
Sorbitol may also be used with a fiber-rich diet and stool-forming foods to maintain bowel regularity.
Suggested read: FODMAP: A detailed beginner's guide
