I have a friend that has been having daily terrible headaches. Headaches she can only manage with daily aspirin. She eats Keto and uses lots of erythritol instead of sugar. She has also eliminated gluten from her diet and is therefore not benefitting from the nutrient fortification in bread. In the past month niacin, folic acid and thiamine have allowed her to stop taking aspirin but she still has a low grade headache that based on her response to thiamine seems would disappear if she stopped using erythritol. So I guess I have more then a .1 level of concern that erythritol can contribute to cardiovascular events.
Reading this was so much fun, thank you. Yup almost don't notice you're learning biochemistry along the way. I really appreciate your way of explaining things.
Mar 19, 2023·edited Mar 19, 2023Liked by Chris Masterjohn, PhD
Chris thank you for taking the fear out of the fear porn. I found the timing of this information a bit suspicious, its reminiscent of the sugar industies promotion the low-fat lipid hypothesis to turn attention away from their products role in heart disease. What else was introduced in recent years that may promote clotting? 🤔 Is it possible this could have elements of diversionary symptom laundering?
I do see what you are saying about the timing, but I see this as a continuation of the Hazen group’s TMAO work. I wouldn’t be surprised if they develop a test around this in the future. They also seem to be very anti-meat, so this might be an attack on low-carb for its animal reliance.
Hi, Chris - As a consumer of copious daily amounts of foods and sweeteners containing erythritol AND someone who has various cardiovascular issues, I was very concerned when I read about the Hazen group/Cleveland Clinic study. It seemed premature to just chuck all the erythritol foods and sweeteners based on one study, but I have been troubled by it.
Your article was JUST what the doctor ordered to help me make more sense of the study and, as judges like to say every day in court regarding evidence and testimony (and as a legal transcriptionist, I get to hear), "I will give it the weight it deserves." I now know just how much that study information should "weigh" LOL.
THANK YOU SO MUCH!
One trivial point to add, which certainly won't change anything about your article, but may be worth noting. I might have misunderstood what you were saying, but it seemed that you were making reference to it not being clear if the subjects were in a fasting state during some of the blood draws and/or cath procedures. This is the part I'm talking about:
-------------------------------------------
"1,5-AHG can serve as a marker of glycemic control because it is found in food, yet glucose concentrations over 180 mg/dL can prevent the kidney from reabsorbing it. Thus, low levels indicate recent hyperglycemia over the course of several weeks. However, acutely, glucose competes for entry of 1,5-AHG into cells and raises 1,5-AHG for up to two hours. So, presumably fasting levels are inversely correlated to hyperglycemia while postprandial levels are positively correlated to hyperglycemia.
The Hazen study found that 1,5-AHG was slightly lower in those with major cardiac adverse events than those without them among their discovery cohort, who were stable subjects undergoing elective cardiac catheterization. The protocol doesn’t say anything about fasting, so it is not clear whether this represents more hyperglycemia or less hyperglycemia among these individuals. However, it is notable that all of them needed or wanted cardiac catheterization, so had some heart problem of some sort."
-------------------------------------------
Just as a point of reference (and you may know this), if you are specifically referring to not knowing if the subjects were in a fasting state during the cath procedures, as someone who is scheduled to have one tomorrow morning (3/17), I can tell you that I am required to fast (no water or food) beginning at midnight in preparation for the procedure. I would imagine that would be the case with any of the study subjects who were undergoing a cath procedure as well. FWIW. Of course, as I said, I think either way, you have more than proven the case to take the erythritol study with a ginormous grain (or 10 or 1,000) of salt.
Thank you again for all you do. You have kept me sane during the entire pandemic. You're amazing!
That’s definitely interesting that fasting is advised but I’m not sure it makes the data make sense, since I doubt diabetes protects against cardiovascular disease! I think it’s more likely 1,5-AHG, due to being displaced by glucose in cells, is a poor marker of recent hyperglycemia. Maybe the postprandial rise is longer than 2 hours with respect to being a market for cardiovascular risk.
Incredibly well-explained, researched and thought-out explanation, Chris. We are all appreciate of your hard work.
Thank you!
This is great analysis!
Chris, thank you do much for your work!
You’re welcome, thanks for the appreciation!
Boy I love your articles. I always look forward to the next one. Thanks.
Thanks!
Thank you so much for the time you put into this.
You’re welcome!
Thanks so much for your thorough investigation of this vexing recent “scary” story.
You’re welcome!
I have a friend that has been having daily terrible headaches. Headaches she can only manage with daily aspirin. She eats Keto and uses lots of erythritol instead of sugar. She has also eliminated gluten from her diet and is therefore not benefitting from the nutrient fortification in bread. In the past month niacin, folic acid and thiamine have allowed her to stop taking aspirin but she still has a low grade headache that based on her response to thiamine seems would disappear if she stopped using erythritol. So I guess I have more then a .1 level of concern that erythritol can contribute to cardiovascular events.
Reading this was so much fun, thank you. Yup almost don't notice you're learning biochemistry along the way. I really appreciate your way of explaining things.
Thanks!
Chris thank you for taking the fear out of the fear porn. I found the timing of this information a bit suspicious, its reminiscent of the sugar industies promotion the low-fat lipid hypothesis to turn attention away from their products role in heart disease. What else was introduced in recent years that may promote clotting? 🤔 Is it possible this could have elements of diversionary symptom laundering?
I do see what you are saying about the timing, but I see this as a continuation of the Hazen group’s TMAO work. I wouldn’t be surprised if they develop a test around this in the future. They also seem to be very anti-meat, so this might be an attack on low-carb for its animal reliance.
Chris I am so grateful for your work, and ability to wade into the details and tease out the truth. Thank you for being you! 💚🙏
You’re welcome, and thank you for the appreciation!
Hi, Chris - As a consumer of copious daily amounts of foods and sweeteners containing erythritol AND someone who has various cardiovascular issues, I was very concerned when I read about the Hazen group/Cleveland Clinic study. It seemed premature to just chuck all the erythritol foods and sweeteners based on one study, but I have been troubled by it.
Your article was JUST what the doctor ordered to help me make more sense of the study and, as judges like to say every day in court regarding evidence and testimony (and as a legal transcriptionist, I get to hear), "I will give it the weight it deserves." I now know just how much that study information should "weigh" LOL.
THANK YOU SO MUCH!
One trivial point to add, which certainly won't change anything about your article, but may be worth noting. I might have misunderstood what you were saying, but it seemed that you were making reference to it not being clear if the subjects were in a fasting state during some of the blood draws and/or cath procedures. This is the part I'm talking about:
-------------------------------------------
"1,5-AHG can serve as a marker of glycemic control because it is found in food, yet glucose concentrations over 180 mg/dL can prevent the kidney from reabsorbing it. Thus, low levels indicate recent hyperglycemia over the course of several weeks. However, acutely, glucose competes for entry of 1,5-AHG into cells and raises 1,5-AHG for up to two hours. So, presumably fasting levels are inversely correlated to hyperglycemia while postprandial levels are positively correlated to hyperglycemia.
The Hazen study found that 1,5-AHG was slightly lower in those with major cardiac adverse events than those without them among their discovery cohort, who were stable subjects undergoing elective cardiac catheterization. The protocol doesn’t say anything about fasting, so it is not clear whether this represents more hyperglycemia or less hyperglycemia among these individuals. However, it is notable that all of them needed or wanted cardiac catheterization, so had some heart problem of some sort."
-------------------------------------------
Just as a point of reference (and you may know this), if you are specifically referring to not knowing if the subjects were in a fasting state during the cath procedures, as someone who is scheduled to have one tomorrow morning (3/17), I can tell you that I am required to fast (no water or food) beginning at midnight in preparation for the procedure. I would imagine that would be the case with any of the study subjects who were undergoing a cath procedure as well. FWIW. Of course, as I said, I think either way, you have more than proven the case to take the erythritol study with a ginormous grain (or 10 or 1,000) of salt.
Thank you again for all you do. You have kept me sane during the entire pandemic. You're amazing!
-Karen :)
Hi Karen,
Glad it helped!
That’s definitely interesting that fasting is advised but I’m not sure it makes the data make sense, since I doubt diabetes protects against cardiovascular disease! I think it’s more likely 1,5-AHG, due to being displaced by glucose in cells, is a poor marker of recent hyperglycemia. Maybe the postprandial rise is longer than 2 hours with respect to being a market for cardiovascular risk.