5 Types of Sugar Substitutes: What to Avoid if You have Tinnitus

By Barry Keate
Barry Keate, has lived with tinnitus over 40 years and has published 150+ research articles on numerous aspects of tinnitus. He is an expert on the condition and a well-known advocate for those with tinnitus.

Packets of various sugar substitutesIn an effort to avoid insulin resistance and diabetes, which can lead to tinnitus, many are shunning sugar by using sugar substitutes. But not all sugar substitutes are alike. Some offer zero calories but come with unhealthy side effects. Other substitutes actually spike blood sugar levels higher than regular sugar. Some can even cause or worsen your tinnitus.

In our article, How Insulin Resistance and Diabetes Cause Tinnitus, we saw that insulin resistance and diabetes are major causes of tinnitus. Between 84% and 92% of people with tinnitus have insulin resistance and/or diabetes, and placing them on a diet suitable for diabetics can lead to major improvements in tinnitus. After two years on this diet, the majority of tinnitus patients had significant reductions in their tinnitus or complete resolution.

It makes sense to wonder, is using sugar substitutes an effective way to avoid not only tinnitus, but also insulin resistance and diabetes? Here we discuss the safety of common sugar substitutes and their effectiveness in avoiding tinnitus and sugar metabolism disorders.

Much of this discussion is based on information from Dr. Joseph Mercola, an osteopathic physician (DO) trained in family medicine, and a fellow of the American College of Nutrition.(1) (DOs are trained in the same way as MDs and are licensed to prescribe drugs and perform surgery, but are more holistic in their approach. They tend to look at the entire body rather than examining specific conditions.)

1 – High Fructose Corn Syrup

High Fructose Corn Syrup (HFCS) has replaced refined sugar in most popular sodas and processed foods in the American market. This is not a low calorie substitute or an artificial sweetener. It is derived from cornstarch and contains more fructose than is found in sugar.

Refined sugar (sucrose) consists of one molecule of glucose linked to one molecule of fructose. These molecules separate during digestion. So refined sugar contains 50% glucose and 50% fructose. By comparison, HFCS contains up to 65% fructose.

Glucose provides energy to cells. Excess glucose passes through the digestive tract and is excreted. It is totally safe.

Instead of being excreted, fructose is processed through the liver, causing increased fat deposits in the abdominal cavity and increased triglycerides in the blood stream. Both of these eventually lead to heart disease and diabetes.

Glucose suppresses the hunger hormone and reduces appetite, telling the brain you are full.

Fructose does not suppress the hunger hormone and interferes with fullness signals from the body. The result is a cycle of overeating, weight gain and obesity.(2) A single soda per day can add up to 15 pounds to a person’s weight over the course of a year. High Fructose Corn Syrup is worse than refined sugar and should be avoided.

Some sodas are still available without HFCS. For example, Coca-Cola made in Mexico uses cane sugar instead of HFCS and tastes considerably better. Mountain Dew products can also be found with cane sugar instead of HFCS.

High Fructose Corn Syrup in soda is the number one source of calories in the United States and is likely the primary cause of the obesity epidemic. Eliminating soda from the diet would reduce sugar and fructose intake and go a long way toward reducing diabetes and obesity in the US. At least people should try to obtain soda products with real sugar.

Let’s review the effects of fructose on the body.

– It tricks the body into gaining weight by fooling the metabolism and turning off the body’s appetite control system.

– It activates a key enzyme that causes cells to store fat.

– It leads to weight gain and abdominal obesity, decreased HDL, increased LDL, elevated triglycerides, elevated blood sugar and high blood pressure.

– Is broken down by the liver just like alcohol and produces many of the same side effects of chronic alcohol use, including fatty liver disease.

– Over time fructose leads to insulin resistance, an underlying factor in Type II Diabetes and heart disease.

2 – Artificial Sweeteners

This group consists of Sucralose (Splenda), Saccharin (Sweet’N Low), Aspartame (NutraSweet, Equal), and a few others used in diet products.

Sucralose is often said to be made from sugar however it is quite different. Sucralose is chlorinated sugar and chlorine is poisonous to the human body. There are many detrimental health effects associated with use of sucralose. All artificial sweeteners impair appetite regulation and promote weight gain much the same way as HFCS does.

Sucralose decreases the amount of good bacteria in the intestines by 50%, increases the pH level of the intestines, affects a protein in the body that makes it more difficult to absorb certain medications, and has been shown to build up in fat cells in the body. (3)

Saccharin may act as a possible carcinogen according to a 1997 report written by the Center for Science in the Public Interest, and needs to be further studied for this, particularly in relation to bladder cancer. (4) It can also cause allergic reactions, lower insulin sensitivity and increased weight gain.

The Journal of Pharmacology & Pharmacotherapeutics noted, “Animal studies have convincingly proven that artificial sweeteners cause weight gain, brain tumors, bladder cancer and many other health hazards.”(5)

Of the artificial sweeteners, Aspartame is among the worst. It damages insulin sensitivity more than refined sugar does. It is also among the most common, used in numerous low-calorie drinks and processed foods.

Aspartame is also ototoxic. It damages hearing and causes or worsens tinnitus. (See our previous article, Neurotoxins and Tinnitus.

An excitatory neurotransmitter, Aspartame also excites brain neurons and increases levels of electrical activity in the brain and auditory cortex. This eventually destroys the neurons and leads directly to hearing loss and tinnitus.

In his book Ototoxic Drugs Exposed, Neil Baumann, PhD, writes, “Common complaints relative to Aspartame include dizziness, tinnitus and loss of equilibrium.”(6)

Aspartame should be avoided like the plague.

3 – Sugar Alcohols

Sugar alcohols are recognized by the “ol” at the end of their name. They include xylitol, sorbitol, mannitol, glycerol and lactitol. These are not as sweet as sugar. They contain fewer calories but are not calorie-free. Products sweetened with them are sometimes labeled “sugar-free,” but the wary consumer will see on the label that they are not calorie-free.

One reason sugar alcohols provide fewer calories is because they’re not completely absorbed by the body. Because of this, eating too much food containing them can lead to abdominal gas and diarrhea.

At times they can have a negative effect on the gastrointestinal system, causing unpleasant side effects. Because these sugar substitutes are not digested in the same way as sugar, they aren’t fully absorbed by the body as they pass through.

Instead, small intestine bacteria ferment these carbohydrates, causing indigestion. You can get gas, bloating and diarrhea from sugar alcohol sweeteners. The packaging of foods containing two sugar alcohols in particular—sorbitol and mannitol—must contain a warning that eating too much of those foods can have a laxative effect.(7)

Unlike other natural or artificial sweeteners, xylitol actively reduces the amount of cavities in the teeth by two-thirds and helps to remineralize damaged teeth. It is frequently used in toothpaste. When taken in the form of chewing gum, lozenges or nasal spray, it also reduces incidence of acute middle ear infection in young children.

Having 33% fewer calories than sugar makes xylitol a lower calorie alternative. It is also absorbed more slowly, so it does not provide a sugar “spike”. It does not contribute to high blood sugar levels or hypoglycemia.(8)

Xylitol is the best of the various sugar alcohols and, in moderation, is a better choice than refined sugar.

There is one caution about using xylitol. It is poisonous to dogs, so be very careful if you have one.

4 – Natural Sweeteners

This group includes agave syrup and honey.

Agave syrup can be considered worse than HFCS, because it has a higher fructose content than any commercial sweetener. The fructose content ranges from 70% to 97%, depending on the brand. By comparison, HFCS contains 55% to 65% fructose.

Honey is also high in fructose. In its natural form it has many health benefits, and it takes time to digest, so it doesn’t cause a sugar spike. However, most honey found in grocery stores is highly processed and of poor quality. Raw honey is harder to find but is a superior product. If possible, find raw, unheated, unstrained honey that contains honeycomb.

5 – Dietary Supplements

These are some of the safest sugar alternatives. Dietary supplements include Stevia, Lo Han Guo and glucose.

Stevia and Lo Han Guo are both plant extracts and are two of the best sugar substitutes. Stevia is a highly sweet herb derived from the leaf of the South American stevia plant. It is sold in health food stores as a supplement. It is completely safe in its natural form and can be used to sweeten most dishes and drinks.

Stevia is different from the sugar substitute Truvia, which is derived from the same plant but uses only certain active ingredients, not the whole plant. Because the synergistic effect of all the compounds in the plant provides the overall health effect, Truvia is not as healthful as Stevia.

Lo Han Guo, also spelled Luo Han Kuo, is a natural sweetener similar to Stevia. It has been used in China for centuries and is about 200 times sweeter than refined sugar. It’s a bit more expensive and harder to find.

Pure glucose costs about $5 to $7 per pound. Its only about 70% as sweet as sucrose, so more is required to achieve the same sweetness; this makes it a little more expensive than regular refined sugar. But it’s well worth it, because it contains no fructose. Every cell in the body can use glucose, unlike fructose, and any excess is safely secreted. It is an excellent sugar substitute.


Some sugar substitutes are safe to use and will not lead to obesity, insulin resistance or diabetes. These include the sugar alcohol xylitol, especially in products related to dental health, and the dietary supplements Stevia, Lo Han Guo, and glucose.

People who already have tinnitus should try to reduce their intake of refined sugar and other sweeteners high in fructose, avoid artificial sweeteners and most sugar alcohols, and adhere to a diet designed for those with diabetes.


1 – http://articles.mercola.com/sites/articles/archive/2013/10/07/sugar-substitutes.aspx

2 – Stanhope KL, Schwartz JM, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J. Clin Invest. 2009 May 1; 119(5): 1322-1334.

3 – http://articles.mercola.com/sites/articles/archive/2009/02/10/new-study-of-splenda-reveals-shocking-information-about-potential-harmful-effects.aspx

4 – http://www.livestrong.com/article/470503-side-effects-of-saccharin-sodium/

5 – Tandel Kr. Sugar substitutes: Health controversy over perceived results. J Pharmacol Pharmacother. 2011 Oct-Dec; 2(4): 236-243.

6 – Neil G. Bauman, PhD. Ototoxic Drugs Exposed: The Shocking Truth About Prescription Drugs, Medications, Chemicals and Herbals That Can (and Do) Damage our Ears. Integrity First Publications 2002.

7 – https://health.umms.org/2022/02/24/sugar-alcohols/

8 – https://en.wikipedia.org/wiki/Xylitol