In the quest to lose weight or maintain a hard-won weight loss, many pain patients turn to sugar substitutes to stay on track. In the past three decades, the pink packet of artificial sweetener has been joined by a wide rainbow of packets and bottles of sugar alternatives. One of these alternatives, stevia, has been advertised as an all-natural and safe sugar alternative, but is stevia safe for pain patients? While research is still in its infancy, there seems to be mixed opinions as to the safety of this increasingly popular sweetener.

What is stevia and is stevia safe?

Stevia is the shortened name for stevia rebaudiana, the plant and leaves that are used as a sweetener. Stevia is in a family of 240 different species, cultivated most successfully in warmer climates.

In its most natural state, the leaves torn off the plant, stevia is very sweet and can be used in tea. Stevia is processed for use by either drying the leaves and grinding them into powder or by pressing the leaves and creating a liquid extract. Both of these processes isolate the steviol glycosides – stevioside and rebaudioside – which are much sweeter than sucrose. Stevioside is measured at between 250 and 300 times sweeter than sugar, and rebaudioside is 350 to 450 times as sweet.

Stevia is viewed as a desirable sugar substitute for those on a weight loss journey because it is a zero calorie sweetener. The other side, of course, is that stevia in both its processed and raw form also has zero nutritional value. The purpose of the plant is for sweetening only.

Is stevia safe: The research

The U.S. Food and Drug Administration has put processed stevia in the “generally regarded as safe” category but has not approved whole-leaf stevia for consumption. Much of the research on stevia has been focused mainly on laboratory animals but has still not been thorough, a huge red flag for David Schardt, nutrition expert with the Center for Science in the Public Interest (CSPI), a consumer advocacy group.

He believes that the FDA’s status was granted prematurely, noting a discrepancy in the testing requirements for this as compared to other foods:

“In the past, FDA protocol required repeated testing in two separate animal species prior to approval, but in this case it didn’t. We are not warning people to avoid [stevia], but the public should be aware that the FDA did not follow all the usual safeguards.”

Regardless, there are some potential benefits to stevia in areas that go beyond weight loss, including:

  • Can lower bad cholesterol: In laboratory rats, low doses of stevia decreased levels of “bad” cholesterol (LDL, or low-density lipoprotein). Low-density lipoprotein is blamed for plaque buildup in the arteries that can lead to heart attack. It should be noted that large doses of stevia had some toxic effects.
  • Helps the body utilize insulin: Another study on laboratory mice found that stevia helped obese, insulin-resistant mice to better utilize insulin.
  • May help control blood pressure: Researchers found in a study of patients with hypertension that 500 milligrams of daily stevioside taken three times a day for two years significantly lowered both systolic and diastolic blood pressure.
  • Low-energy sweeteners can help with weight loss: A study from the UK found that low-energy sweeteners like stevia did, in fact, help curb “energy intake” (essentially calorie consumption) without increasing body weight.

Is stevia safe for pain patients?