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Your Healthy Sweetener Choices

By Dr. Janet Starr Hull

Life is full of choices. What to wear – which car to buy – what colored packet sweetener to use.  White, pink or blue? Now, there’s a new yellow packet of chlorinated sweetener called sucralose to choose from. Have you ever considered using a natural sweetener or no added sweeteners at all? 

The following is an alphabetized list of the best natural choices for sweeteners that are safer for long-term health as opposed to the refined sugars and the artificial chemical sweeteners. Remember nothing is without consequence. Natural is always a better choice, but all of these alternatives should be eaten in moderation, as most can impact blood sugar levels. It is best to use any type of sweetener, even the all-natural ones, sparingly, if at all, with the optimal choice being to savor the natural flavors in your food and resist the urge to add extra sweetness.

Natural sweetener choices:

“Grey area” sweeteners (those that are natural, yet are either slightly altered in laboratory processing or naturally tend to spike blood sugar):

New natural sweeteners:

A Quick Glance at the Natural Sweetener Choices:

BARLEY MALT: Barley malt is a thick, dark, slow-digesting sweetener made from sprouted, roasted barley grainwith a nutty, malt-like flavor.Barley malt can be bought in granular form or as syrup. It is called “malt” because maltose is the sugar that occurs when starch in the barley sprouts. Barley malt is used in brewing beer, and some say barley malt is to beer as grapes are to wine. It is ideally suited to brewing for many reasons:

Barley malt extract is used medicinally as a bulking agent to promote bowel regularity.Because the malt comes from sprouted barley, the malt can be concentrated into a soluble fiber, so it has laxative qualities similar to psyllium, oats and the pectin in fruits. Beneficial bacteria in the colon uses barley fiber for food. Barley malt is helpful in chronic constipation, irritable bowel syndrome, diverticulosis, hiatal hernia and diabetes. Soluble fiber can even lower cholesterol ten percent to fifteen percent.

Because barley malt is an actual food sugar, it should be refrigerated for extended storage.

BROWN RICE SYRUP: Rice syrup is made by slow-cooking brown rice until it develops thick sweet syrup. Few people have allergies to rice, so this offers an alternative sweetener choice for consumers with allergies or asthma, particularly children. Rice syrup has a light flavor because it is a food. There is no need to refrigerate rice syrup. If the syrup hardens, simply run the jar under warm water.

DATE SUGAR: Date sugar is made by dehydrating and pulverizing dates. The date fruit has a high concentration of naturally occurring sugars. This particular sugar does not dissolve well, but it is acceptable for cooking and baking. Date sugar should be stored in a cool, dry place.

Date sugar is high in fiber and contains a long list of vitamins and minerals, including iron. Substitute one-cup date sugar for each cup granulated sugar for a better choice of sweeteners.

HONEY: For centuries, honey has been referred to as “nature’s gold.”  After gathering the nectar from flowers and flowering plants, bees return to the hive and process the nectar as honey. (Local bee pollen, the precursor to honey in the hive, is great for allergies.) The flavor of the honey reflects upon the flower. Sources commonly include buckwheat, blackberry, heather, clover, orange blossoms, wildflowers and sage. To process raw honey, remove it from its wax comb, strain or heat and filter. The downside to this process is that heating the honey destroys many of its natural enzymes and nutrients. For this reason, I highly recommend you seek out a source of raw honey, which is a much healthier alternative to the commercial pasteurized honey in most supermarkets. You can find raw honey in some health food stores or from local farmers.

Honey should be stored in a dry place. If the honey begins to crystallize, place the jar in a pot of hot water until the sugar crystals dissolve. Be careful not to make the water too hot or you risk damaging the nutrients. Honey contains the following nutrients: protein, thiamin, riboflavin, niacin, vitamin C, calcium and iron.Topical application of honey to infected wounds is an ancient remedy, and one that has been confirmed by many scientific studies.

MAPLE SYRUP AND MAPLE SUGAR: Thirty-five to fifty gallons of maple tree sap boil down to one gallon of maple syrup. Classified by color and flavor, the lighter the syrup color (Grade A), the lighter the flavor. The grades of syrup have more to do with taste than quality. The darker the color, the longer the syrup has usually boiled, veering it farther from its natural state. Maple syrups and sugars should be refrigerated.

MOLASSES: The liquid that is spun out of refining cane sugar is molasses. Molasses is twenty percent to twenty-five percent water, fifty percent sugar and ten percent ash, with some protein and organic acids remaining. Molasses is graded by color and sugar content, with the lighter color containing more sugar. So look for the darker grades. Because of its very strong flavor, molasses is used mainly in baking and should be kept cool or refrigerated.

SORGHUM: Sorghum is a grain related to millet. It is processed into a sweetener by crushing the plant stalks and boiling the extracted juice into syrup. Sorghum is comparable to molasses but is much lighter and milder tasting. Sorghum should be refrigerated.

STEVIA: Stevia is 250 to 300 times sweeter than sugar. It is isolated and purified from the leaves of the stevia plant.Stevia has been used as a traditional remedy for diabetes and gum disease among the indigenous people of Paraguay and other South American countries for over 1,500 recorded years. (Who knows how many years prior to the records?) Preliminary scientific evidence (performed by independent researchers) shows stevia may indeed improve the function of cells required for insulin production in the pancreas, and may also improve glucose tolerance in people with diabetes. But according to the generations of people who have used stevia as a part of their daily diet, stevia has been proven to regulate blood sugar and is used as a treatment for diabetes and gum disease.

Stevia has been reported to possess anti-viral activity, and preliminary evidence suggests that stevia possesses blood pressure lowering properties and may be a useful treatment for hypertension.

I feel stevia is a much safer alternative compared to the artificial chemicals created in corporate laboratories, especially for use during pregnancy, for children and for diabetics who stand to benefit from its soothing glucose effects. Of course, the key to eating anything properly, whether chemical food replacements or one hundred percent natural foods, is to maintain moderation in its use and monitor your artificial chemicals carefully.


SUCANAT®Sugar Cane Natural: Sucanat is a natural granulated sweetener with a higher nutrition level and a lower sugar level than refined sugar (88.3% vs.99.9%). Fresh cane juice is pressed from the sugar cane stalk and then dehydrated through a co-crystallization process. It is through this process that Sucanat granules are formed. Sucanat granules are an improvement over bleached sugar crystals in shape and function. Unlike processed sugar crystals, Sucanat granules are round, porous and easily compressed, and can be used in the “sugar bowl” as refined sugars are used, but are a much healthier alternative.

Product qualities include:

Note: Liquid natural sweeteners (barley malt, brown rice syrup, honey and maple syrup) can be stored at room temperature in the original packaging, but should be refrigerated after opening. Dry, powdered alternative sweeteners should be stored in a dry place at room temperature. Fruit juice concentrates should remain frozen until ready to use.

A Quick Explanation Of The “Grey Area” Sweeteners:

FRUCTOSE: Fructose becomes a simple sugar by refining corn syrup or extracting beet sugar. Because it breaks down more slowly in the body than sucrose, it has a somewhat lesser effect on blood-sugar levels, but it does not provide any nutritional benefits. Also known as levulose and fruit sugar, fructose is the sweetest of all the simple sugars. Fruits naturally contain between one percent and seven percent fructose, although some fruits have much higher amounts. Fructose makes up about forty percent of the dry weight of honey. It is also available in crystalline form, but its sweetness rapidly declines when dissolved in water. Some people react badly to fructose, so it is not a recommended option for those who need to restrict sugar intake.

In fact, I do not recommend fructose as an acceptable form of sugar for anyone despite its acceptance in many nutritional circles. The reasons for this are many:

The digestive and absorptive processes for glucose and fructose are different. Unlike glucose, which the body uses for energy, when you consume large amounts of fructose, it supplies a relatively unregulated source of fuel for the liver to convert to fat and cholesterol. Fructose converts to fat more than any other sugar.

Further, most fructose is consumed in a liquid form, which significantly magnifies its negative metabolic effects. The devastation it has on our biology would be significantly lessened if it was consumed in solid food, but most fructose is consumed in soft drinks and fruit juices. This is one type of sweetener I don’t advise anyone to add to his or her diet. Note: This does NOT apply as strictly to the fructose ingested in whole fruits. Eating balanced amounts of natural fruits provides less “adulterated” fructose than provided in manufactured forms of fructose products, posing less of a problem for most people. Caution is advised for diabetes or obesity.

FRUIT JUICE CONCENTRATE: This sweetener undergoes little processing, but most people don’t think about sweetening with fruit concentrates. It can be used to sweeten more products than you’d think, such as cookies, candy, cereal and sodas. Fruit juice concentrate is usually made from a concentrate of pineapple, pear, and peach or clarified grape juice. They can be used much more safely than artificial sweeteners when sweetening gelatin, unsweetened powdered drinks and fruit smoothies.

Most fruit juice concentrates are frozen, so keep in the freezer until ready for use.

SUGAR ALCOHOLS: I am not a fan of sugar alcohols extracted from their natural sources. Sugar alcohols are actually made from sugar. Part of their structure chemically resembles sugar and part is similar to alcohol. To complicate matters more, these sweeteners are neither sugars nor alcohols—they are best described as a sugar byproduct refined by nature. Sugar alcohols fall into a “grey area” in the sweetener arena because they are actually carbohydrates (starches) more than they are sugars. They are typically used cup-for-cup in the same amount as refined sugar, but they each vary in sweetness, ranging from half as sweet to as sweet as sugar. Sugar alcohols blend well with other sugars, so they are commonly added to products such as gums, candies and mints, toothpaste and mouthwash. Please keep in mind, these “grey area” sugar alcohols can give people gastric distress if consumed in excess.

Included in this group are:

Sugar alcohols are used in a wide range of low-calorie, low-fat and sugar-free foods from baked goods to frozen dairy desserts since they provide bulk without all the calories of sugar. Sugar alcohols do not commonly promote tooth decay, so are used in toothpastes, mouthwashes, breath mints and pharmaceuticals such as cough syrups, cough drops and throat lozenges.

THE DOWNSIDE OF SUGAR ALCOHOLS: Some of the sugar alcohols that are not absorbed in the blood are broken down into fatty acids in the large intestine. People on low-carbohydrate diets or who have diabetes may not respond well to the sugar alcohols in place of sugar because some people report that sugar alcohols act as "trigger foods," causing carb cravings or binges.

Since the intestine does absorb the sugar alcohols, over-consumption can produce a laxative effect in some people. Excessive use can cause gas or laxative effects similar to reactions to beans and certain high-fiber foods. Such symptoms depend, of course, on an individual's sensitivity, health status, and what other foods are eaten at the same time. Another positive way to look at it—your body may be showing you its limit on how much sugar it really needs by  “kicking out” too much.

The table below provides a summary of each of the different sugar alcohols currently used in U.S. food products. Nutrition labels include them as either "Sugar Alcohols" or under their individual name.

How do sugar alcohol calories compare with raw sugar? Sugar provides approximately 4.0 calories per gram:

0.2 calories per gram                  erythritol

3.0 calories per gram                  hydrogenated starch hydrolysates

2.0 calories per gram                  isomalt

2.0 calories per gram                  lactitol

2.1 calories per gram                  maltitol

1.6 calories per gram                  mannitol

2.6 calories per gram                  sorbitol

2.4 calories per gram                  xylitol

1. Erythritol is an odorless white, crystalline powder with a clean sweet taste approximately seventy percent as sweet as sugar. Like most sugar alcohols, erythritol does not promote tooth decay. It has approximately seven percent to thirteen percent the calories of other sugar alcohols and five percent the calories of sugar. Because erythritol is rapidly absorbed in the small intestine and rapidly eliminated by the body (within twenty-four hours), laxative side effects are sometimes associated with excessive use.

2. Hydrogenated Starch Hydrolysates (HSH) are a mixture of sorbitol, maltitol and hydrogenated oligosaccharides. Depending on the type of HSH desired (the maltitol and sorbitol content can be varied), the sweetness of HSH varies from twenty-five percent to fifty percent that of sucrose. HSH sweeteners are used in a wide variety of candies, gums and mints. Also known as maltitol syrup and hydrogenated glucose syrup, just remember to read your labels!

3. Isomalt is a complex carb (one of the better sugars) and approximately forty-five percent to sixty-five percent as sweet as sucrose. Isomalt is used in candies, gums, ice cream, jams and jellies, fillings and frostings, beverages and baked products. As a sweetener/bulking agent, it has no off-flavors and works well in combination with other sweeteners.

4. Lactitol is a sweet-tasting complex carb (another good sugar) derived from lactose. Lactitol provides the bulk and texture of sugar with half the calories. Thirty percent to forty percent as sweet as sucrose, it is used in: baked goods, chewing gum, confections and frostings, frozen dairy desserts and mixes, candy, jams and jellies.

5. Maltitolis a complex carb produced by the hydrogenation of maltose, the sugar found naturally in sprouted grain. It occurs widely in nature in chicory and roasted malt. About 0.9 times as sweet as sucrose with similar sweetness and body, maltitol is suitable for many kinds of candies, gums and mints, and is particularly good for candy coating.

6. Mannitolis a simple carb (simple sugar), approximately 0.7 times as sweet as sucrose. Used as a bulking agent in powdered foods and as a dusting agent for chewing gum (interesting!), excessive consumption of more than twenty grams a day may have a laxative effect. Mannitol has been removed from the GRAS (Generally Recognized As Safe) list, and is regulated as an 'interim' food additive. This means that its current use is considered safe, but some questions have been raised that must be resolved to fully determine what limitations, if any, should be imposed. Mannitol is permitted for use in many countries, including the United States.

Sorbitol (see below) and mannitol are readily converted in the body to fructose and glucose. The problem with these sweeteners is they are slowly absorbed from the intestines and may produce a laxative or gaseous effect, and may affect blood sugar levels more than the other sugar alcohols, so they may not be the better choice for diabetics.

7. Sorbitolis another simple carb sixty percent as sweet as sucrose. Excessive consumption of more than fifty to eighty grams a day may have a laxative effect. Sorbitol is also a sugar alcohol the body uses slowly. It is called a nutritive sweetener because it actually has four calories in every gram, just like table sugar. Sorbitol is found naturally in fruits and is an ingredient in many sugar-free gums, sugar-free breath mints and dietetic candies.

Did you know that sorbitol is also produced by the body? Too much sorbitol in your cells can cause damage, though. Diabetic retinopathy and neuropathy may be related to too much sorbitol in the cells of the eyes and nerves.

CAUTION: Some foods contain sugars that are absorbed slowly, such as fructose in fruit juice or sorbitol in low-calorie sweets. Through a process called osmosis, these unabsorbed sugars hold onto water in the intestines, which sometimes leads to diarrhea. By reading labels, people with chronic non-infectious diarrhea can easily avoid fruit juice, fructose and sorbitol to see if this eliminates the problem.

8. Xylitol seems to be the “favored child” of the sugar alcohols. It is a simple carb, though, extracted from birch tree pulp. The wood sugar “xylose” was first hydrogenated to produce xylitol in 1891 by the German chemist Emil Fischer. Xylitol has been used since the 1960s in the Soviet Union, Germany, Switzerland and Japan as a favored sweetener for diabetics. Xylitol is also used intravenously for patients with impaired glucose tolerance, i.e. for trauma, burns, and in diabetic and insulin-resistant states.

Xylitol is a naturally occurring sweetener also found in:

Xylitol does not require insulin to metabolize in the body and does not promote tooth decay. Xylitol has the same sweetness, bulk and caloric value as sucrose, so it is one of the most popular sweetener alternatives used in candies, chewing gum and natural-ingredient toothpastes, foods such as gum drops and hard candy, and in pharmaceuticals and oral health products.

Because xylitol helps prevent plaque and cavities, it is a better choice for sugarless gums than aspartame or sucralose. But in the long term, you are better off using neither sugar nor natural unprocessed sugars. As with most sugar alcohols, consumers with hypoglycemia, Candida or diabetes may react negatively to xylitol.

SOMETHING TO WATCH FOR: Kelly Goyen, Founder/CEO of Empirical Labs has observed children with AD/HD react in the same fashion to Xylitol as to aspartame or high doses of refined sugar. “Xylitol passes through the blood-brain barrier,” Goyen states, “and we have observed at our laboratory that after using Xylitol, hypersensitive children become more “active” shortly after use.”

TAGATOSE, labeled Naturlose® for use in pharmaceuticals and toothpaste, tagatose hopes to “take over the market” according to marketing experts. Tagatose, discovered in 1981, is a partially digestible sugar made from whey. It claims to be all natural and low calorie, and almost as sweet as sucrose. It is being studied for unsafe effects on infants and pregnancy, however. Currently, the license contract for tagatose is tied up in arbitration and its patent as a food additive expires in 2008.

Even though fertility issues are under scrutiny, company executives for Sperix (Naturlose manufacturer) claim their sweetener product enhances fertility and high pregnancy rates in laboratory rats fed tagatose, prevents biofilm (bacteria that forms on teeth and medical instruments) and enhances key blood factors critical to fighting anemia.

Tagatose is synergistic with other sweeteners (which is a plus for sweetener blends in Chapter Four) and can improve texture and “mouth-feel” in sugar-free products. Potential uses for tagatose include candies, gums and mints, ready-to-eat cereal, ice cream and baked goods. The Kellogg Company, Battle Creek, Michigan, has received a patent for the use of tagatose in ready-to-eat cereal and other foods.

TURBINADO® SUGAR is the light brown crystalline substance removed from molasses during the first separation of processing, moving from a complex sugar (that doesn’t pass into the blood stream) to a simple sugar (that passes into the blood). Although Turbinado contains trace nutrients, it is identical to white sugar in the way it is absorbed by the body. Turbinado should be stored in a cool, dry place.                 

A Quick Explanation Of New Sweeteners:

LO HAN: The Chinese plant Lo Han Guo Siraitia grosvenorii is a perennial vine in the cucumber, melon, squash and gourd family. Lo Han fruits are used both inside and outside the People's Republic of China as a food, beverage and traditional medicine. Although millions of Lo Han fruit are consumed worldwide each year, Lo Han fruits in Europe and the United States are mostly sold by Chinese grocery and herb stores. The current uses and potential of Lo Han Guo are as a food, seasoning, beverage or non-caloric sweetener plant.

The Chinese book “Fruit as Medicine” (Dai and Liu, 1986) reports these fruits are used for heat stroke (with thirst), acute and chronic throat inflammation, chronic cough, constipation in the aged, and as a sugar substitute for diabetics. In general, the preparation is to boil or simmer the fruit in water and drink it as an herb tea. As a sugar substitute in cooking, the fruits may be simmered into a thick juice and added to food. The prepared block form called "Luohanguo Chongji" is reported to be a popular treatment for colds in China.

TREHALOSE®: Trehalose is one of the most interesting new sweeteners on the market today, and I felt it was worth including in this chapter primarily due to the “honesty in advertising” the company has expressed about their new product. I should probably classify Trehalose as a grey-area sweetener because no one really knows enough about it to date, yet it appears a solid product backed by sound science. This sweetener is a disaccharide (a good carb) with two glucose molecules (a better choice for diabetics because it is a complex carb), but the thing that impressed me the most is the company’s honesty in admitting that Trehalose is fully digested and metabolized. Finally, someone admits their sweetener is digested! This is the most “natural” form of sugar metabolism.

Cargill Health & Food Technologies, makers of Trehalose, markets the new sweetener for sports drinks. In November 2003, PacificHealth Laboratories, Woodbridge, NJ, announced the launch of a ready-to-drink form of its sports drink, Accelerade®. It provides the energy (from complex sugar carbs) needed in sports, according to the company representatives. I’d rather see an athlete drink pure water for body restoration, but Trehalose appears a better choice than the other artificial sweeteners, and that’s all athletes have to choose from when it comes to low-carb sports drinks and energy bars.

Trehalose is found naturally in honey, mushrooms and other foods. One thing I am concerned about, though, is Trehalose is commercially produced from cornstarch, which can cause allergic reactions and stomach irritations in some people. Its functions include coloring adjunct, flavor enhancer, humectant, nutritive sweetener, stabilizer, thickener and texturizer. Trehalose can also protect and preserve food’s cell structure, which can help maintain food texture during freezing and thawing. Trehalose is found in candies, gums and mints, processed foods, such as dried vegetables and fruits, and dairy and fruit products.

YACÓN®:  Yacón is not a commercial sweetener yet, but look for this natural sweetener coming to the American market in the near future. A distant relative of the sunflower, yacón grows from Venezuela to Argentina in small farm orchards in the inner mountain valleys. Yacón is a natural plant root with a rich sweet flavor. In spite of its sweetness, Yacón is composed of complex plant sugars, so it will not penetrate the intestines and contribute to weight gain. This is also a plus for diabetics because Yacón contains traces of inulin.

Inulin is a chemical believed to improve blood lipid levels and is currently being studied as a pre-cancer nutrient. Recent animal research shows that inulin prevents adverse precancerous changes in the colon. Inulin is recommended for diabetics, and because it is not absorbed into the bloodstream, it does not affect blood sugar levels. Inulin has a mildly sweet taste, and is filling like starchy foods. It is a preferred food for the lactobacilli in the intestine and can improve the balance of friendly bacteria in the bowel.

Yacón can be eaten raw, just like a fruit, and once the roots have been dried in the sun, they become sweeter. Expect this new sweetener sometime in the near future.

Sweetening Tips

Don’t use any added sugars at all. Ideally, learn to appreciate the natural sweetness of your food. The more natural the food, the sweeter the taste. This is always the best option!

Use more spices and herbs when preparing meals instead of adding sweetness.

If eating a dessert, choose a natural fruit. Apples, cheese, grapes, fruits and nuts are common desserts in European countries. If you must sweeten, select from the safe sweetener list.

Honey can be used to replace sugar in a recipe: 3/4 cup of honey can replace one cup of sugar in a recipe. You will have to reduce the liquid by one-half cup for each cup of honey you add to the recipe though.

If you want to cut down on your total intake of sugar, consider decreasing all sugars—white, brown, powdered, raw, as well as honey. You could limit your intake of foods high in sugar to once a week rather than eating sweets daily. Another significant reduction in sugar could be made by adding only one-half to one-third the amount of sugar or honey called for in a recipe. You will be surprised how good cookies taste with half the sugar. There are also many healthy recipes out there that call for no added sugar at all!

Instead of trying so hard to sweeten your food, wouldn’t it be refreshing if you were satisfied with fresh berries or a simple piece of fruit? Maybe this should be your goal—to return your taste buds to normal stimulation. So, have an apple or a cup of berries before you reach for that colored packet of sweetener.


Report. The Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives (JECFA).

0-.alpha.-D-glucopyranosyl-D-sorbitol (1,1-GPS), mannitol, sorbitol, hydrogenated or non-hydrogenated oligosaccharides.

Stevia and Stevioside. Foods Stands Agency. March 27, 2002.

Stevia toxicity.

Department of Health & Human Services.


Mung bean.

Posted on March 14, 2005 in Artificial Sweeteners | Link To This Entry | Comments (5)


Posted by: frances on March 14, 2005 8:08 PM

I have found a sweetener called agave nectar. It comes light and dark. The maker, Sweet Cactus Farms, claims it has been studied to have a low glycemic index of only 11. You can check them out at I would like to hear an opinion though from someone professional other than the maker of a product.


Posted by: mj on March 22, 2005 3:43 PM

agave does have a low GI index, however, it is 90% fructose (beware). Stick to natural fruits for your sugar intake.


Posted by: Dr. Janet Starr Hull on March 22, 2005 5:56 PM

Agave is 90% fruit sugar (fructose) content. Because it breaks down more slowly in the body than sucrose, fructose has a somewhat lesser effect on blood-sugar levels, but it does not provide any nutritional benefits if extracted from its source. Also known as levulose and fruit sugar, fructose is the sweetest of all the simple sugars. Fruits naturally contain between one percent and seven percent fructose, although some fruits have much higher amounts. Obviously, Agave contains a higher amount of natural fructose, which is better than extracted and processed types. Some people react badly to fructose, though, so it is not a recommended option for those who need to restrict sugar intake. Unlike glucose, which the body uses for energy, when you consume large amounts of fructose, it supplies a relatively unregulated source of fuel for the liver to convert to fat and cholesterol. Fructose converts to fat more than any other sugar.

Just be careful on the amount you consume each day, but this is a better choice than manufactured sugars and sugar substitutes. Definitely better for the kids.


Posted by: Dr. Russell R. Bingman on May 11, 2005 6:55 AM

I have been using NuNatural's White Stevia Powder for several months now. Just 1/8th to 1/4 teaspoon is all you need. I love the taste and as I continue to research, the more I am persuaded that it is a great "natural" sweetener, beneficial to all of us diabetics, and beneficial to our health. I've found no negatives or side effects.


Posted by: leon jay on October 16, 2006 9:16 PM

i have antibiotic caused peripheral neuropathy and used splenda. stopped using it three days ago and my pain and nmbness have diminshed significantly


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