Stevia Side Effects: Good or Bad?

Stevia Good or Bad Title The stevia plant has been used for over 1500 years by the Guaraní people of Brazil and Paraguay, who refer to stevia as ka’a he’ê, which means “sweet herb”. These native South Americans love using this non-caloric natural sweetener in their yerba mate tea, as medicine, and as a sweet treat. (1)

In these South American countries, stevia has also been used specifically as a traditional medicine for burns, stomach problems, colic and even as a form of contraception. (2)

Stevia extract is typically about 200 times sweeter than sugar. When it comes to using stevia,  you only need a tiny bit at a time to sweeten your morning tea or next batch of healthy baked goods. Stevia side effects are typically not common, especially if you choose the right stevia product.

I’ve been fielding a lot of questions about stevia lately and have seen several articles and  other sources online claiming that there may be some negative stevia side effects. Isn’t stevia an herb? And aren’t herbs supposed to be good for us? If so, then why all the fuss? I’m going to answer all of your questions in this article and lay out for you both the good and the bad about how stevia affects your health.

What is Stevia Really?

There are approximately 200 plus species of stevia that grow in South America. What is stevia? Stevia is an herbal plant that belongs to the Asteraceae family so it’s related to ragweed, chrysanthemums, and marigolds. Stevia rebaudiana is the most prized variety of stevia.

In 1931, chemists M. Bridel and R. Lavielle isolated the two glycosides makes stevia leaves sweet glycosides — stevioside and rebaudioside. (3) Stevioside is sweet but also has a bitter aftertaste that many complain about when using stevia while rebaudioside is better tasting, sweet and less bitter.

Most “raw” and less processed stevia products contain both sweeteners where as most highly processed forms of stevia, like Truvia, only contain the rebaudioside; the sweetest part of the stevia leaf. Rebiana or rebaudioside A is is “generally recognized as safe” by the Food and Drug Administration (FDA), and is used as an artificial sweetener in foods and beverages. (4) This is not a form of stevia I recommend.

As you’re about to see in the research, using the “whole” stevia leaf that also contains stevioside has some great health benefits, but using certain brands of stevia that have been processed and added to is not a good or health-promoting option.

Is Stevia Safe? Are there Stevia Side Effects?

Most people do well with stevia, but listen to your body because stevia is an herb and everyone’s body may react differently to it. The benefits and possible side effects of stevia really depend upon what stevia you choose to consume.

Highly refined varieties of stevia are considered by the FDA to be GRAS or generally recognized as safe. Since highly processed stevia starts as a natural substance, but gets so significantly refined, they find it hard to label stevia products like Truvia. The FDA labels highly processed types of stevia as a novel sweetener.  Novel sweeteners are combinations of various types of sweeteners. (5)

The FDA has not approved whole-leaf stevia or crude stevia extracts as GRAS, although they are much more natural than the stevia products they have given their stamp of approval. With whole-leaf and crude extracts, benefits are greater and negative stevia side effects are less likely.

When it comes to the stevia options available today, it’s vital to know that not all stevia is created equal. You should be aware of the three main categories of stevia including green leaf stevia, stevia extracts, and altered stevia (like Truvia).

Green leaf stevia is the least processed of the stevia types. The leaves are basically just dried and ground into powder form.  This is the type of stevia that has been used in South America and Japan and South America for centuries as a natural sweetener and health remedy. This type of stevia is about 30-40 times sweeter than sugar.

Some brands that make stevia extracts extract the sweeter and less bitter part of the stevia leaf (rebaudioside) which doesn’t have the health benefits found in stevioside.  This type of stevia may be a better option than other regular sweeteners but there aren’t many studies available yet showing it’s effects.

The worst option of is altered and overly processed “stevia” like Truvia. It’s really not stevia at all by time a product like Truvia goes through a 42 step process to make this processed sweetener.  First, the rebaudioside is extracted from the stevia leaf then, chemical solvents are added including acetonitrile which is toxic to the liver and is a carcinogen.  They then add in a GMO corn derivative called erythritol. (6) Truvia or rebaudioside stevia products are about 200 to 400 times sweeter than sugar. (7)

Negative stevia side effects

This point cannot be stressed enough: not all stevia products are created equal. There is a HUGE difference between consuming real stevia and chemically processed stevia products like Truvia.

Truvia only contain less than one percent stevia. (8) Yes, you read that correctly — LESS THAN 1%!  Truvia is really barely a stevia product, but people unfortunately believe that this sweetener is natural and harmless. If you avoid Truvia and choose the right stevia product then stevia dangers are basically non existent. Unless of course, you have a ragweed allergy (more on that later).

There is a 1999 study that indicates stevia decreases the fertility of male animal subjects. The amount of stevia is not specified, but it was administered for 60 days. The concern is that stevia extracts could effect hormones because its glycosides have a similar structure to plant hormones like gibberellin. (9) But many herbs including ginkgo biloba also have this natural component  and if consumed in moderation it’s a non issue. Follow-up studies have also found that stevia has no effect on hormones.

Stevia Manufacturing Process Diagram

5 Health Benefits of Stevia

Regarding the good stuff, we have found that there are several studies (463 stevia studies to be exact and that number is ever increasing) evaluating stevia’s ability to be used as a natural remedy. There are medicinal properties in the plant itself that lend to its incredible healing and disease-fighting effects.

1. Anti-Cancer Abilities

In 2012, Nutrition and Cancer highlighted a groundbreaking study that, for the first time ever, connected stevia consumption to breast cancer reduction. It was observed that stevioside, enhances cancer apoptosis (cell death) and decreases certain stress pathways in the body that contribute to cancer growth. (10)

The journal Food Chemistry published a study out of Croatia showing that when stevia is added to natural colon cancer killing mixtures such as blackberry leaf, antioxidant levels soar. (11)

2. Sweet News for Diabetics

Using stevia instead of white sugar can be extremely helpful to diabetics who need to avoid conventional sugar as much as possible. But they also shouldn’t be having artificial chemical sweeteners. Human and animal studies have demonstrated that artificial sweeteners can raise your blood sugar levels even more than if you consumed the real stuff (table sugar). (12) Now that should make you think twice before picking up that next diet soda!

Enter stevia. An article published in Journal of Dietary Supplements evaluated how stevia affects diabetic rats. It was discovered that rats treated with 250 and 500 milligrams every day “significantly” reduced fasting blood sugar levels and balanced insulin resistance, triglycerides and alkaline phosphatase (which is raised in cancer patients). (13)

Another study of human female and male subjects found that having stevia before a meal reduce reduced post meal blood glucose and insulin levels. These effects appear to be independent of reductions in caloric intake. This research demonstrates how stevia can possibly assist with glucose regulation. (14)

3. Helps Weight Loss

Consuming added sugars has been shown to contribute an average of 16 percent of the total calories in the American diet. (15) This high sugar intake has been linked to weight gain and adverse effects on blood sugar, two things that can have serious negative impacts on health.  Stevia is a plant-based, zero calorie sweetener. If you choose to replace health hazardous table sugar with a high quality stevia extract and use it in moderation, it help you to decrease not only your overall daily sugar intake, but also your caloric intake. By keeping your sugar and calorie intake in a healthy range, you can help to fend off obesity as well as many health problems linked with obesity like diabetes and metabolic syndrome.

4. Improves Cholesterol Levels

Results of a 2009 study showed that stevia extract had “positive and encouraging effects” on overall cholesterol profiles. It’s important to note that they also found that there were no adverse effects on the health status of the subjects involved in this stevia study. Researchers concluded that stevia extract effectively decreases elevated serum cholesterol levels including triglycerides and LDL (“bad cholesterol”) while increasing HDL (“good cholesterol). (16) You could say stevia results in the best of both worlds when it comes to cholesterol numbers.

5. Lowers High Blood Pressure

“Available research is promising for the use of stevia in hypertension,” says Catherine Ulbricht, senior pharmacist at Massachusetts General Hospital in Boston and co-founder of Natural Standard Research Collaboration, which reviews scientific evidence on herbs and supplements. Ulbricht said Natural Standard gave stevia a “grade B for efficacy” in reducing blood pressure. (17)

Certain glycosides in stevia extract have been found to dilate blood vessels and increase sodium excretion, two things which are very helpful to keeping blood pressure at a healthy level. Evaluation of two long-term studies (1 and 2 years in length, respectively) give hope that stevia may be effective in lowering blood pressure in hypertensive patients. However, data from shorter studies (one to three months) did not support these findings. (18)

Sweetener Comparison Infographic

3 Types of Stevia:

1. Green Leaf Stevia

  • Least processed of all types of stevia
  • Unique because most natural sweeteners contain calories and sugar (like honey), but green leaf stevia has no calories or sugar
  •  Used in Japan and South America for centuries as a natural sweetener and health remedy
  • Taste: sweet, slightly bitter and isn’t quite as potent as most stevia products
  • 30-40 times sweeter than sugar
  • Has been shown to benefit blood sugar levels, cancer, cholesterol, high blood pressure and weight loss.
  • Best option, but still should be used in moderation.

2. Stevia Extracts 

  • Most brands extract the sweeter and less bitter part of the stevia leaf (rebaudioside) which doesn’t have the health benefits found in stevioside.
  • No calories or sugar
  • Taste: sweeter than green leaf stevia
  • About 200 times sweeter than sugar

3. Altered/Barely Stevia like Truvia

  • Extensive processing and added ingredients make the end product barely stevia at all
  • Contains GMO ingredients
  • No calories or sugar
  • Truvia or rebaudioside stevia products are about 2oo to 400 times sweeter than sugar
  • Avoid, worst option
  • Side effects like gastrointestinal problems (19)

Organic Stevia vs. Non Organic

Organic stevia:

  • Made from organically grown stevia
  • Typically non-GMO
  • No glycemic impact
  • Gluten-free

Unfortunately, even some organic stevia contains fillers. Some aren’t truly pure stevia so you always have to read labels if you are looking for a 100% stevia product. For example, one brand of organic stevia is actually a blend of organic stevia and organic blue agave inulin. Agave inulin is a highly processed fiber derivative from the blue agave plant. While this filler is not as concerning as a GMO ingredient, it’s still a filler.

Non organic stevia:

  • Biggest difference — Does not have to be made from organically grown stevia
  • Also tends to be non-GMO unless it’s a highly processed stevia
  • No glycemic impact
  • Typically gluten-free

Stevia Leaf Powder vs. Stevia Leaf Liquid Extracts

  • Products vary, but in general, stevia leaf extracts are 200 to 300 times sweeter than table sugar.
  • Powder and liquid stevia extracts are much sweeter than crude stevia leaves or green herbal stevia powder that are anywhere from 10 to 40 times sweeter than table sugar.
  • Whole-leaf stevia or crude stevia extracts aren’t FDA-approved
  • Liquid stevia can contain alcohol so look for alcohol-free versions
  • Liquid stevia extracts now come in flavors like vanilla and hazelnut
  • You can get stevia leaf extract in convenient packet form
  • Some powdered stevia products contain inulin fiber, which is a naturally occuring plant fiber

Stevia vs. Sugar vs. Splenda


  • 0 calories and 0 grams of sugar
  • Depending on what you brand you pick, can be very minimally processed from its original leaf state
  • No common adverse side effects with the use of stevia
  • Can purchase the pure dried leaves online and grind them up using a spice grinder (or mortar and pestle)
  • Straight stevia leaves are only 30-40 times sweeter than sugar vs. 200 times using stevia extract


  • 1 tsp of a typical table sugar contains 16 calories and 4.2 grams of sugar. (20)
  • Typical table sugar is highly processed compared to its original state as sugar cane
  • Overconsumption of sugar can also lead to the dangerous build up of fat on the inside that we can’t see. This fat around their vital organs can cause serious disease in the future, like: weight gain, diabetes, heart disease and some cancers. (21)

Sucralose (Splenda) 

  • Although derived from sugar more specifically sucralose, the chemical structure has been significantly changed
  • Highly processed
  • Originally was going to be a pesticide
  • 0 calories and 0 grams sugar per serving (22)
  • 600 times sweeter than sugar (23)
  • Is heat-stable, meaning that it does not break down when cooked or baked
  • Used in many diet foods and drinks, chewing gum, frozen dairy desserts, fruit juices, and gelatin
  • Many common negative side effects including migraines, dizziness, intestinal cramping, rashes, acne, headaches, bloating, chest pain, tinnitus, gum bleeding and more.

Best Place To Find + How To Use

You can find a good stevia option at your local health store or online. Make sure to buy stevia without additives and one that has been less processed. I recommend green stevia as the best option.

If you want to try green stevia powder I recommend Organic Traditions.  Another good brand of stevia that tastes great and you can find it pretty much any health food store is SweetLeaf® stevia. SweetLeaf® has zero calories, zero carbs, a non-glycemic response, and no artificial sweeteners. (23)

You can also buy ground stevia leaf online, and a huge bag lasts a long time. You can also buy whole dried leaves and ground them yourself. If you are purchasing products already sweetened with stevia, make sure “whole leaf stevia” is on the ingredient label.

You can use stevia powder or liquid stevia extract in place of sugar in your coffee or tea. You can also use it in baking recipes or any other recipe that recommends including sugar. It’s important to realize that a little bit of stevia goes SUCH a long way. You need so much less stevia in comparison to sugar. Conversions will vary depending on your specific stevia product.

Helpful general conversions using a stevia product like SweetLeaf®: (24)

  • 1 teaspoon sugar = 1/2 packet or 1/8 teaspoon powdered stevia = 5 drops liquid
  • 1 tablespoon sugar = 1.5 packets or 1/3 teaspoon powdered stevia = 15 drops liquid stevia
  • 1 cup of sugar = 24 packets or 2 tablespoons powdered stevia = 2 teaspoons liquid stevia

Unfortunately, if you are looking for caramelization in a dessert, stevia does not brown like regular sugar.

Stevia Precautions

Stevia safety is generally good, but if you have a ragweed allergy then it is highly possible that you could have an allergic reaction to stevia and products that contain stevia. Signs of an oral allergic reaction include swelling and itching of the lips, mouth, tongue and throat, hives, abdominal pain, nausea, vomiting and a tingling sensation in the mouth and throat. Discontinue use if this occurs and seek medical attention if symptoms are serious.

Some people find that stevia can have a metallic aftertaste. No general stevia contraindications or adverse reactions have been identified. If you’re pregnant or breast feeding, stevia safety information is unfortunately lacking. You can check with your doctor, but it’s probably best you avoid stevia, especially since whole stevia leaves have traditionally been used as a contraceptive. (25)

In general, seek medical advice before using stevia if you have an ongoing medical conditions or are taking other medications.

Stevia Final Thoughts 

Using stevia in place of white sugar means getting rid of one of the primary dietary causes of chronic and deadly health problems like diabetes, obesity, heart disease and cancer.

As more companies use stevia or some synthetic version of it in their products, you’re probably going to hear more negative press about it. Especially products that are marketed as natural when they truthfully only contain less than a percent of stevia. It’s pretty unbelievable what companies can get away with. You just have to make sure that you choose a good brand that includes no harmful fillers, use it only in small amounts, and listen to your body.

Josh Axe

Dr. Josh Axe is on a mission to provide you and your family with the highest quality nutrition tips and healthy recipes in the world...Sign up to get VIP access to his eBooks and valuable weekly health tips for FREE!

Get FREE Access!

Free eBook to boost
metabolism & healing

30 Gluten-Free Recipes
& detox juicing guide

Shopping Guide &
premium newsletter