A Story About a Sugar: The X-Factor

xylitol benefits

Amazing Stories, 1938
Public Domain, from Wikimedia Commons

I want to tell y’all a little story about a sugar – Xylitol.

Cool name. Sounds a little futuristic. In my mind, any name with X’s or Z’s sounds like something from a 1950’s scifi movie. Maybe an alien name.

First, to see the full image, click on the image that accompanies this blog post – it is the cover from a 1938 publication of Amazing Stories. Not only is that appropriate for the story of Xylitol, but it’s just a cool image.

Sounds alien. But it’s not. It’s natural, grown right here on Earth.

Xylitol is a naturally-occurring sugar substitute. It is found in nature in various fruits and vegetables, but is usually prepared for human consumption by extracting it from corn or other vegetable sources.

Xylitol was discovered late in the 19th century.

Since then, it has been shown to have many benefits:

  1. Xylitol has about 1/3 fewer calories than table sugar (sucrose)
  2. Xylitol has about the same sweetness for taste as table sugar
  3. Xylitol has a low glycemic index – this makes it safer for diabetics
  4. Xylitol consumption reduces growth of yeast (Candida)
  5. Xylitol in the diet reduces dental caries
  6. Xylitol inhibits the growth of various species of bacteria
  7. Xylitol inhibits the attachment of various bacteria to the mucosal lining of our respiratory tract
  8. Xylitol increases neutrophil activity in experimental models (rats)
  9. Xylitol reduces sinusitis in experimental models (rabbits)

Most of these benefits have been demonstrated from human studies. The features #5-7 above are probably responsible for the reduction in ear infections in clinical trials!

Only those last couple – #8 & 9 – are from experimental animal studies. Those have not yet been studied in humans, but the findings are encouraging.

Bottom line: most bacteria and yeast (fungus) cannot easily metabolize Xylitol. They prefer a 6-carbon sugar like glucose (Xylitol is a 5-carbon sugar). Incorporation of Xylitol into the surface polysaccharides of our mucosal cells – lining our aero-digestive tract – prevents bacteria from adhering to the surface. If the bacteria cannot stick to the lining of your nose, or your throat, they cannot have their evil way with you. You win.

What HAS Been Studied in Humans?

Xylitol and Otitis Media

Xylitol has been found to reduce the incidence of acute otitis media – ear infections – in children.

Now we’re getting to the interesting stuff, no?

In the 1970’s there were studies from Finland that showed significant reduced ear infections in children who chewed gum that was sweetened with Xylitol instead of sucrose or fructose. These results have been reproduced in multiple clinical trials in children.

So now you’re thinking, “Well, that doesn’t do me much good, my 1-year-old with the ear infections can’t chew gum.”

That thought occurred to Dr. Lon Jones, too.

Dr. Lon Jones, and Jerry

Image: Dr. Lon Jones, and Jerry

He was treating otitis media in children, looking for ways to prevent it, to treat it, without surgery.

So he asked whether there were other ways to get Xylitol into children. His goal was to get Xylitol into children without changing their diets, but to get the Xylitol to the area it is needed to achieve the benefits listed above – namely, to reduce adherence of bacteria, to inhibit growth of bacteria and yeast – in the upper respiratory tract of children.

Dr. Jones settled on a simple solution: he added Xylitol to salt water and used it as a nasal spray in children. His clinical trials found a similar reduction in ear infections to those already seen for Xylitol-chewing gum.

So: Xylitol can reduce ear infections. Big up-side benefit.

What is the downside?

None known.

Xylitol in saline nose spray is a safe means of reducing ear infections, and reducing upper respiratory infections in general.

If this is so effective, must cost a lot, no?

No. Xylitol is cheap, cheap. The Xlear patented brand of Xylitol nasal spray can be found online for less than $10. This brand has the optimal concentration of Xylitol to help prevent ear infections and sinus infections, based on medical studies. (Most other sprays that list Xylitol on their ingredients contain only the minimal concentration to be able to meet legal requirements to list it as an ingredient. Scammy.)

If this is so effective, why haven’t I heard about it before?

Perhaps it’s because there are no big pharmaceutical companies behind the product. No advertising.

I’m not a conspiracy-theorist. It is just a simple fact that a generic, inexpensive product like Xylitol cannot make a company a lot of money. As a result, there are no big advertising campaigns behind Xylitol.

So, what are you waiting for?

Xlear Saline Nasal Spray with Xylitol

Image: Xlear Saline Nasal Spray with Xylitol

If YOUR child has recurrent or chronic ear infections, frequent URI’s, rhinitis, or sinusitis, why not give Xylitol a try? Your kids will LOVE the Sparx candies, made from Xylitol (mine do).

 

Transparency:

  1. I have no financial arrangements with Xlear or Spry. Be sure to look on Amazon for Xylitol products.
  2. After reviewing the medical literature and all available data, I DO use Xlear Xylitol products for myself and my family, and recommend them for my clinic patients.
  3. After using Xlear products, and reading Dr. Jones’ books, I made an effort to meet him (and his wonderful wife, Jerry). For complete transparency, I consider them friends.
  4. This site is an Amazon affiliate, and will make some pennies from any purchase through the Amazon Store link. Yes, pennies :))

_______________

Hi, I’m Russell Faust, author of this blog, and I appreciate your comments and questions.  Keep ‘em coming.  Please, “be excellent to one another.”

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Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor :~D)

 

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Comments

  1. Thanks for all the GREAT xylitol info! I have a much better understanding of the benefits and how it works : )

    • Russell A. Faust, PhD, MD says:

      Ryan,
      Thank YOU for your kind comments, and thanks for visiting.
      Let me know what information to add that might be of value for you.
      Boogs

  2. Thanks, Dr. Faust, for telling me about Xylitol! I had no idea. There is a documentary by Brian McKenna (?) called “Big Sugar” that will curl your toes. I will add Xylitol to my arsenal of sinus cures. I like the idea of this spray for airports and travel!
    Your fan,
    Sinus Sister

    • Russell A. Faust, PhD, MD says:

      Hi SS,
      The combination of probiotics and nasal saline spray (or rinse) containing Xylitol can reduce sinus infections and ear infections by up to 50%! What’s not to love? And yes, the little spray bottle of saline with Xylitol (Xlear.com) is great for travel.
      Thanks so much for taking the time to visit, and for your comments.
      RF (boogs)

  3. englishrosesloverain says:

    Xlear is amazing, I switched to it after a bad sinus infection for which I was prescribed Sudafed and Flonase. Still taking the Sudafed but ditched the Flonase because it gave me oral thrush! Apparently after inhaling Flonase (which puffs your face up-it is a steroid after all!) you are supposed to rinse your mouth out with water to prevent candida forming. It doesn’t say that anywhere in the instructions so two days later ta-da! my very own yeast infection.

    I have taken care of that by rinsing with GSE.

    • Russell A. Faust, PhD, MD says:

      Yeah, Xlear is pretty good stuff. Great for kids, too, because the sweet taste doesn’t turn them off.

  4. Kevin & Colette Lidle says:

    We are so happy to stumble across this information. Kevin is 41 and suffers from chronic ear infections and sinus issues. We are going to order these products! We can’t wait to see if this helps! We will keep you posted. Thank you!

  5. Hi!! I have a 3 yr old that is being diagnostic with asthma and allergic rhinitis the ped have him on Flonase, singulair, Qvar and albuterol and I’m so scare because I think is too much med for my little baby, we being with this for a month and still w same symptoms, any suggestions??? I had 3 different Pediatricians all say the same thing, same medications …Don’t know what else to do :( .

    • Russell A. Faust, PhD, MD says:

      Hi Jaditza,
      There are always options. I strongly urge you to get a copy of Dr. Rosen’s “Treatment Alternatives for Children” (affiliate link on boogordoctor’s Amazon Store). It’s a wonderful resource, and it compares “standard Western” therapies like you list, with evidence-based alternative remedies, as I try to do here on this blog site.
      Please keep me updated.
      Best success!

  6. Bret Budrick says:

    Hi Dr. Faust,

    My name is Bret Budrick. I spoke with you by email about Xylitol. You were very helpful and thorough. I appreciate that. I was curious about how Xlear nasal spray changes the environment in the nose good or bad. You said that Xlear does change the environment over time because the pathogenic/harmful bacteria cannot survive on it. I had a couple follow up questions on these topics:

    1. Does Xlear get rid of or change good/beneficial bacteria in the nose as well? Basically how does Xlear choose specifically only bad bacteria to get rid of or change over time? Isn’t it hard for beneficial bacteria to metabolize xylitol, just like the bad bacteria?

    2. Does Xlear change the environment in the nose permanently or just while you are using it? In other words does this environmental change go back to an individual’s normal environment once Xlear use is tapered off?

    Thanks a lot Dr. Faust. I am excited to hear your response.

    • Russell A. Faust, PhD, MD says:

      Hi Bret,

      You are correct: Xlear uses a higher concentration of xylitol than most, to their advantage.
      Dr. Lon Jones did some of the research that guided his selection of that concentration for the Xlear products. It is not toxic to tissues, only pathogenic bacteria.

      Yes, 11% xylitol does change the nasal/sinus microbiome over time, toward a more beneficial balance, at least if you are experiencing chronic rhinosinusitis (CRS). That is one of the benefits of adding the xylitol: xylitol is difficult or impossible for many pathogenic bacteria to metabolize. That helps your immune system to kill them.
      In addition, xylitol in the micro-environment results in your mucosal lining cells using xylitol as they produce various cell-surface receptor molecules – proteoglycans – that incorporate xylitol in place of other sugar molecules.

      It just happens that pathogenic bacteria use those surface proteoglycans to adhere to the mucosal surface. That allows them to escape the mucho ciliary clearance mechanism, and is the first step in their invasion of the mucosal layer. That is, adherence is their first step to infecting you.
      When those proteoglycans are made using xylitol, those pathogenic bacteria have a hard time adhering. Can’t stick, can’t infect. Just another benefit of xylitol. And there are other, more subtle mechanisms, too. Bottom line: xylitol in nasal rinses for those with CRS is a good thing. Helped me finally put an end to my own CRS, after decades.
      Xylitol also helps if your goal is to make hyper osmotic saline rinse: you can increase the solute concentration using xylitol instead of adding more salt (that can burn).
      I often make my own rinse using the usual salt-packet, and adding xylitol to about 10%. I buy the xylitol on Amazon. I actually have it listed on the website on the boogordoctor Amazon Store.

      Thanks for visiting, for sharing.

      • Bret Budrick says:

        Thanks for your response Dr. Faust. It was very informative and interesting.

        I am not sure if you meant to, but this was more a response to my initial quetions about Xylitol/Xlear. I had two more questions above that I have always been very curious about, and it has been hard for me to find an answer.

        Here are the question again, thanks as always:

        1. Does Xlear get rid of or change good/beneficial bacteria in the nose as well? Basically how does Xlear choose specifically only bad bacteria to get rid of or change over time? Isn’t it hard for beneficial bacteria to metabolize xylitol, just like the bad bacteria?

        2. Does Xlear change the environment in the nose permanently or just while you are using it? In other words does this environmental change go back to an individual’s normal environment once Xlear use is tapered off?

        Take care Dr. Faust.

        • Russell A. Faust, PhD, MD says:

          Hi Bret,
          Sorry for the oversight.
          GREAT question – you would think that xylitol would have a pretty equal effect on good (or neutral) bacteria and pathogenic, bad bacteria. I would expect that to be the case, and it may be. Research shows that xylitol decreases pathogenic bacterial infection overall, so the balance is positive. It may be the OTHER benefits of xylitol that actually make the bigger difference, I’m not sure. For example, it is the pathogenic bacteria that have evolved all their special attachment receptors in order to adhere and invade the mucosal surface. Xylitol interferes with that.
          I read your 2nd question to be: “is the effect of xylitol on the nasal / sinus microbiome permanent, or only temporary, while it is being used?” (let me know if I’m not getting it right).
          The way I think of it is this: the direct effects are probably only during actual use, and I would expect that to taper off after stopping use of xylitol in the rinses. However, the effect can be long-lasting, because of the changes made to the nasal and sinus microbiome. That is, the xylitol helps eliminate the pathogenic bacteria, allowing for restoration of a “normal” microbiome balance of microorganisms. THAT can be long-lasting.
          For example, for my own patients who have struggled with chronic rhino-sinusitis (CRS), and for my own CRS, adding the xylitol to the nasal rinses made a huge – and long-lasting – difference.
          Hope that answers your questions.
          Thanks for sharing here on the website so that we can all learn from each other. I won’t be surprised if one of the readers here has some additional insights or better explanation.

      • Kevin Forsen says:

        Dr. Faust, thank you for providing this information.

        I have adopted the use of a hypertonic saline solution and adding a few drops of baby shampoo. The improvement in just a day was incredible. I have been using two salt-packets with 250 ml of water. How much Xylitol should I add to bring it to 10%?

        Thank you so much for this website and it’s information!

        Sincerely,
        Kevin

        • Russell A. Faust, PhD, MD says:

          Hey Kevin, You are so welcome. Thank YOU for the feedback, really appreciated. I use about one tablespoon of Xylitol, even if it doesn’t all dissolve because of the hypertonicity of the solution (including the salt, bicarb, and Xylitol), but the higher concentration works well. Also note that the brand, Xlear, provides little packets for saline plus Xylitol – I buy mine from Amazon (NetiXlear Saline with Xylitol – affiliate link).
          Thanks again for visiting and for sharing. Please keep me updated, and best success!

  7. Hi Dr. Faust, my daughter used to use a Grapefruit Seed Extract nasal rinse for her allergies, and it really seemed to help, but after I read some disturbing info that many GSE products contain triclosan and/or other chemicals and contaminants, we stopped buying it. (http://www.drweil.com/drw/u/QAA400888/Is-Grapefruit-Seed-Extract-Any-Good.html)

    I just today purchased Xlear nasal spray for my son’s recurrent ear infection issues, but noticed on the label that it also contains GSE. From your blog, I see that you use Xlear, so I’m hopeful that you’ve been able to confirm the purity of that particular product, or that you have other information that confirms most GSE is actually safe to use.

    • Russell A. Faust, PhD, MD says:

      Hi Christy,
      Thank you for providing that link, and for pointing out the controversy surrounding grapefruit seed extract. As a matter of fact, I do not have information regarding the purity of the GSE in Xlear products. I can tell you that I use them for myself and my family, and have been delighted with their quality, and with my own results. Thanks so much for visiting, and especially for sharing. Please do keep me / us informed with any further information you uncover; I will do the same.

      • Thank you. Do you have any recommendations for a wholistic ENT in the Cincinnati area?

        • Russell A. Faust, PhD, MD says:

          Hi Christy,
          I checked out the AIHM.org website (Academy of Integrative Health & Medicine), clicked on “find a practitioner” and looked for a holistic ENT in your area. The only name that came up was mine :(
          My recommendation is to (1) ask around; (2) check the holistic periodicals at places like Whole Foods for ads from holistic practitioners local to you; (3) visit a naturopat (Doctor of Naturopathy, ND) who will take a more holistic, integrative approach to your health (my own personal physician is an ND)
          Thanks for visiting, and best success.

  8. Dr faust,
    Thank you for such a wonderful website full of helpful information. My three year old suffers chronic nasal infections. She is scheduled for adenoid removal after trying every remedy in the book. That being said we just started using baby shampoo in her nasal irrigator. Would it be safe to pour a probiotic tablet into the solution of saline to restore bacteria in the nose? If so, is there a certain strand of probiotic that I should use? Thanks again

    • Russell A. Faust, PhD, MD says:

      Hi Jenn,

      In my opinion, the adenoids can be a reservoir for chronic infections with pathogenic bacteria – there is no downside to removing the adenoids. You’re not the first person to ask me about putting probiotics into the nasal saline rinses. Honestly, I’ve never tried it; if you do, please let me know how it goes.

      Adding probiotic directly to nasal saline rinses may not provide much benefit. Here’s why: we think that the way probiotics work by ingesting them is that the probiotic bacteria bind to the surface of enterocytes (the cells lining the gut) in the small intestine; through complex biochemical cell pathways, this binding stimulates the gut-associated-lymphoid tissue (GALT), which then alters systemic biochemicals of the immune system (cytokines).

      On the other hand, it may be that adding probiotics to nasal saline rinses will bind those beneficial bacteria to the lymphoid tissues in the upper respiratory system (adenoids; palatine tonsils, etc) and have the same effect? I don’t know.

      Regarding brand of probiotic: because the beneficial effects from ingesting probiotics only result when they affect the GALT in the small intestine, the probiotics must actually GET to the small intestine, and be alive when they do. Stomach acid kills most probiotics you ingest – unless they are enteric-coated. That means that stomach acid kills virtually all of the liquid and powder-forms of probitoics that are old for children. There are only a couple enteric-coated probiotics available. We use Integrative Therapeutic Probiotic Pearls for ourselves and for our children (disclaimer: NO financial or other relationship with Integrative Therapeutics).

      Thanks so much for your kind comments, for visiting, and for sharing. Best success, and please let me know how it goes.

  9. I am fighting sinusitis (chronic) and Candida seems to be a culprit to its growth so my doctor suggested the xylitol rinse. Curious, will I get a Candida die off effect from he use of this like I did when I started the Candida diet?

    • Russell A. Faust, PhD, MD says:

      Candida cannon metabolize Xylitol. Xylitol should be a regular part of your “candida diet” regimen.

  10. Greg shumaker says:

    I love your last name, haha.

    But yeah this post is amazing. Big fan of finally finding some legitimate well researched medical blogs. I usually have to spend time searching through medical research online to try to figure out if something is legit before I try it.

    I’ve had a sinus infection for almost 2x months and I’m going to sprint to the store right now and try this!!

    I’ll be reading more of your writing too. Being able to convey things simply is worth a lot. It’s my strength as an engineer and seems to be a big strength of yours as well

  11. I had the ballon sinus procedure back in Oct 2016 and I already have a really bad sinus infection, which is really frustrating. I bought the Xlear nasal spray and have been using for a couple days, which I’m really hoping will help. Fingers crossed because I’m not sure what to try next.

    • Russell A. Faust, PhD, MD says:

      Hi Emily:

      If your history of sinus troubles was bad enough to warrant balloon sinuplasty, you should consider regular (daily) nasal saline rinsing as part of your life. Like brushing your teeth. It will help. And it may be years until you can decrease doing saline rinses. I know…it’s a hassle, and unpleasant. (I hate doing saline rinses, but they help!). But doing saline rinses is a small price to pay for avoiding sinus infections.

      Thanks for visiting, and sharing. Best success!

  12. Amanda Reifsnyder says:

    Hello Dr. Faust,

    Re: assisting with colds, would Xlear be something that you would use preventatively (daily) or at the onset of symptoms?

    Thanks so much!
    Amanda Reifsnyder

    • Russell A. Faust, PhD, MD says:

      Hi Amanda:

      You can actually add Xylitol to your diet…you can use it in place of sugar for baking, in iced-tea, or coffee, of any other use you would have for granular sugar. But start slowly: most humans don’t digest Xylitol easily, and it can cause GI upset. On the plus side, Xylitol has a low “glycemic index,” meaning that it does not spike you blood sugar like other sugars.

      One benefit of adding Xylitol to your diet is that Xylitol will be incorporated into the surface glycosamino-glycan (GAGs) on your respiratory epithelial cells. It is those GAGs that act as receptors for pathogenic (bad) bacteria to attach to respiratory tract so they can infect you. The addition of Xylitol during synthesis of those GAGs helps prevent bacterial adherence, thereby reducing infection rates.

      And, when used in nasal saline rinses, it’s perfectly OK to add Xylitol on a regular, daily basis.

      Thanks so much for visiting and sharing your question! Best success.

  13. Hi Dr. Faust,

    How often do you recommend applying xylitol nasally to treat a sinus infection, and is the spray as effective as the full neti pot rinse?

    Thanks!

    Luke

    • Russell A. Faust, PhD, MD says:

      Hi Luke:
      Nothing is as effective as daily nasal saline rinses. On the other hand, performing nasal saline rinses at work can be inconvenient (there’s an understatement!), so using those little squeeze-spray-bottles can be handy.
      When I have an active sinus infection, I add Xylitol to every saline batch – can’t hurt: no down-side, plenty up-side (unless you’re allergic to Xylitol, in which case don’t use it :))
      One other thing, I prefer a squeeze-bottle (BPA-free, thank you) to the neti pot, for a little more force and the ability to perform saline rinses without cranking my neck into odd positions that can be necessary to use the neti. My favorite is from Nasopure – here is the affiliate link on Amazon
      Thanks for visiting, sharing, and best success

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