Sweeteners are used for making foods to become tastier. They also play a role in improving the active shelf-life of foods. They help in enhancing the pleasure of consuming foods which are otherwise not palatable. By adding sweetness, they also balance the salty content of edibles. Sweeteners can be either natural or artificial. Natural sweeteners are derived from plants while synthetic sweetening agents are man-made. Among natural sweeteners, products such as sugar, molasses, stevia, etc. are widely used. Of these, stevia is made from leaves of a shrub cultivated mostly in South America and in a few other parts of the world. It helps to know more on stevia and the likely side effect it may trigger.

Do you have a sweet tooth but you want to avoid taking sugar? Stevia may have an answer to your dilemma. Stevia is a natural sweetener and is used as a sugar-substitute. The leaves have been in use for several centuries in South America, especially in countries like Paraguay, Brazil, etc. The extracts of stevia are used in sweet dishes, to add taste to drinks like juices or teas and as a reliable herbal drug. Almost zero-calories present in stevia and a stable pH value add to its popularity. In countries as far as Japan, use of stevia is already part of common cuisine for many years now. In the EU, additives made from stevia are already cleared for use. In the US, the food and drug administration (FDA) has cleared the use of glycoside extracts of stevia as safe, in general.

Clinical studies done on stevia underscore its ability to act as a substitute for sugar – especially, for those living with diabetes, people who are obese, those who need to watch over their bodyweight and for younger adults or children. Receptors of taste are known to respond well to extracts of stevia by sending “sweet” signals. These signals play a critical part in enhancing sweetness experienced by your taste buds. Stevia was popularly considered as a supplement to decrease blood sugar level. But, more evidence is required on its efficacy and how it can benefit those with diabetes. Similarly, the effectiveness of stevia to bring down hypertension needs more trials and awaits more conclusive evidence. Apart from these two conditions, use of stevia as a line of treatment for loss of bodyweight, cardiac conditions, acid reflux, etc. are under advanced research.

Side effects of stevia

Foremost of all, you need to remember, two active ingredients of stevia – mainly, rebaudioside as well as stevioside – are considered as generally safe. In general, their use as a substitute for sugar is unlikely to cause major adverse side effects. Regulatory agencies monitoring safety of foods, supplements, additives, etc. have cleared its key ingredients as a safe, natural sweetener. In controlled clinical settings, use of stevioside for as high as 25 months did not trigger acute reactions or allergic effects. In such research, daily intake of stevia extracts has been checked to a maximum dosage of 1400 milligrams (mg) for such long time periods.

Diabetes mellitus and stevia

People living with diabetes are advised to check with their treating physician about intake of stevia. It is mainly because of use of stevioside is likely to reduce blood sugar level. So, if you are taking drugs to keep blood sugar under control, you may find it difficult to exert effective control. In general, you are advised to check blood sugar levels regularly. Any significant drop in sugar levels need to be quickly reported to your physician. If left unchecked, you may experience symptoms of low sugars – such as, feeling hungry, persistent spells of thirst, dizziness, palpitations, passing out or fainting.

Common side effects of stevia

A few people who took extracts sourced from stevia developed abdominal discomforts such as nausea, gas, flatulence and bloating. In a small number of people, it has triggered side effects like muscular cramps or pains, feeling of numbness, mild level of drowsiness or dizziness. In some people, intake of stevia has caused hormonal imbalances; especially, a marked increase in production of progesterone was observed in a few people. As progesterone plays a key role in menstrual periods as well as helps during the first trimester of pregnancy, a disrupted level of the hormone is considered unsafe.

If you are living with frequent spikes in blood pressure levels and are taking antihypertensive drugs, you need to be careful with intake of stevia. This is because of an excessive drop in blood pressure level – i.e., episodes of hypotension. Low pressure may show up with a few typical signs such as headache, breathing problems, tiredness, pain in the upper-back region, etc. Upon noticing any of these symptoms, you are advised to stop taking stevia and consult your treating doctor for needful instructions. As a safety measure to avoid a severe drop in blood pressure, it is important to share the type of sweeteners used as part of your daily diet plan.

Stevia works like a water pill and its impact on kidneys

As per directives of food regulatory bodies like the FDA, it is not recommended to take more than 4 mg of stevia (or its equivalents) per kg of body mass. As stevia also works like a water pill or a diuretic, it can enhance the rate at which fluids or salts are discharged along with urine. With such enhanced discharges, your renal system may come under added stress. It is hence likely that a long term intake of stevia can potentially impair your renal wellbeing by damaging the kidneys. However, a few recent studies also indicate stevia and its extracts’ ability to protect your kidneys. This protection is rendered at a cellular level; intake of stevia is linked to reduction of risks associated with formation of cysts in the filtering cells of kidneys.

Pregnant women and intake of stevia

Women who are pregnant or those planning to become pregnant need to consult a qualified medical professional before starting to consume stevia extracts. There are not many established evidences on the safety of these extracts on pregnant women. A few studies indicate high doses as well as persistent use of stevia may have serious implications on pregnant women and the functioning of their cardiac system, renal health as well as urinary tract including health of urinary bladder. High doses taken during pregnancy can lead to headaches, weariness, hypotension, drying of lips, etc. It is hence generally advised to refrain from taking stevia or its extracts while you are expecting a baby.

Women who are breastfeeding are also advised not to take stevia while they are feeding their newly born baby. It is because of lack of conclusive evidence on the extent of its ingredients that pass through mother’s milk. The possible effects experienced by the feeding infant are also not fully studied. It is hence a good practice to talk to your treating physician and pharmacist for proper medical advice. In general, it is considered safe not to consume stevia while you are breastfeeding.

Are you allergic to a few plants or plant-based extracts?

Plants of the same genre or species are likely to have properties in common. Plants such as daisies, ragweed and marigold form part of the same family as stevia. You need to know that all these plants belong to the asteraceae family. So, if you are allergic to plants belong to this genre – it is likely that you may develop allergic reactions upon taking stevia. Some may have allergies to sunflower and it seeds; such allergies are also likely to trigger some reactions when you consume stevia. As a preventive measure, you need to share details about possible or know allergies with your treating doctor as well as dietitian. Intake of stevia is often discontinued when allergic reactions like inflammation, soreness of throat, respiratory problems like gasping, wheezing or shortness of breath are observed.

Prior medical conditions and risks of side effects linked to stevia

People who are living with a few medical condition are advised to be wary of taking stevia. It is hence a good practice to share details about prior medical conditions with your treating doctor, pharmacist and dietitian. Intake of stevia is considered harmful for people with conditions like cardiac diseases or disorders, hormonal imbalances, those who consume chemo medicines, renal dysfunction, etc. As mentioned, people with blood sugar conditions, hypertension or hypotension also need to extremely cautious while consuming this natural sweetener.

Risks and possible side effects of using counterfeited extracts

Most of the studies done on safety aspects of stevia are mainly performed on its refined forms – namely, rebaudioside and stevioside. But, many manufacturers are known to use less-refined extracts of stevia. Impact of consuming such products is not adequately clear. Also, the use of laves or unrefined extracts of stevia are also not covered by clinical studies thus far. Owing to the increased (and fast growing) popularity of stevia, many spurious and substandard manufacturers have forayed into its manufacture.

Lab-based research done on stevia-based supplements sold in groceries reveal the use of unhealthy ingredients. Most of these products are likely to carry several health risks and associated side effects. Chemicals found in stevia supplements include sodium crystals of saccharin, aspartame, sodium salts of cyclamate maltodextrin, etc. As a general precaution, you are advised to buy products sold by reputed manufacturers. In this light, stevia supplements made with 96 percent glycosides of steviol are generally considered as safe.

In sum, stevia and its extracts are gaining ground in many parts of the world. The common side effects of taking the active ingredients of stevia include abdominal discomforts such as nausea, flatulence, formation of gas, bloating, etc. A few rarely observed discomforts or side effects are muscular pains, cramping, spasms, numbness and feeling dizzy. Purely refined glycosides are considered safe and are unlikely to trigger major side effects; however, some labels in stores may contain impure variants. If you are allergic to plants like sunflower, ragweed, daisies or those belonging to the asteraceae genre of plants, your doctor needs to know about it. If you develop serious allergies like swelling of lips or breathing problems, you are advised to consult your doctor as quickly as possible. Those living in the US may also call 911 or contact a local poison control center. People living in Canada may call Health Canada for needful medical help on an urgent basis.

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