Sorbitol, a common sweetener in many foods, is a sugar alcohol, which means it is neither a sugar nor an alcohol in the sense that most people understand those words, but chemists have their classification systems and sorbitol’s chemical structure is such that, with its hydroxyl groups each attached to one carbon atom, it’s a sugar alcohol.

So, what’s the problem?

We’ll cut right to the chase: it can be indirectly quite harmful to the liver.

To understand why, first understand how fructose is so bad for the liver. It’s so bad, because while glucose and fructose (the monosaccharides found in equal parts in the disaccharide that is sucrose, i.e. table sugar) both ultimately get converted into glycogen (if not used immediately for energy), but for fructose, this happens mostly* in the liver, which a) taxes it b) goes very unregulated by the pancreas, causing potentially dangerous blood sugar spikes.

This has several interesting effects:

• Because fructose doesn’t directly affect insulin levels, it doesn’t cause insulin insensitivity (yay)
• Because fructose doesn’t directly affect insulin levels, this leaves hyperglycemia untreated (oh dear)
• Because fructose is metabolized by the liver and converted to glycogen which is stored there, it’s one of the main contributors to non-alcoholic fatty liver disease (at this point, we’re retracting our “yay”)

Read more: Fructose and sugar: a major mediator of non-alcoholic fatty liver disease

^{*”Mostly” in the liver being about 80% in the liver. The remaining 20%ish is processed by the kidneys, where it contributes to kidney stones instead. So, still not fabulous.}

Now know this: sorbitol can be converted very quickly and easily into fructose (oops!)

Researchers (Dr. Madelyn Jackstadt et al.) found that if you have sufficient quantities of certain Aeromonas bacteria, they degrade sorbitol into harmless byproducts, but without them sorbitol passes to the liver, where it is converted into fructose and fructose derivatives.

However, you cannot rely on “well, I’m pretty sure my gut is in good shape”, because excess sorbitol—whether eaten directly or generated from high glucose intake—can overwhelm even those beneficial bacteria.

You can find the paper itself, here: Intestine-derived sorbitol drives steatotic liver disease in the absence of gut bacteria

What should we use instead?

Honestly, there are no sweeteners that we’re aware of that have no drawbacks.

Simply sweetness itself can cause problems: we can build tolerance to sweetness. Many sugar substitutes are many times (in some cases, hundreds of times) sweeter than sugar. This leads to people craving increasingly sweeter foods for the same experiential sweetness level.

Because of this, the World Health Organization has released a report offering guidance regards the use of sugar-free sweeteners.

In a nutshell, the guidance is: don’t

• Here’s the report itself: Use of non-sugar sweeteners: WHO guideline
• And it was based on this huge systematic review: Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis
• Here’s the WHO’s own press release about it: WHO advises not to use non-sugar sweeteners for weight control in newly released guideline

Nevertheless, if you really want to, we previously did a rundown on:

• Sucrose (metabolic problems)
• Sucralose (genotoxic)
• Erythritol (ischemiagenic)
• Xylitol (gut disruptor)
• Acesulfame K (gut disruptor)
• Stevia (strong risk of sweetness tolerance problem)
• Glycine (beneficial in moderation, sweetness problem though)

For more details than those one-or-few-word summaries, see: What’s The Healthiest Sweetener?

We’ve also talked about: The Fascinating Truth About Aspartame, Cancer, & Neurotoxicity

…which covers how the most popular beliefs about aspartame are myths, and in large part stemming from a single viral hoax chain letter in the 90s!

Want to do more for your liver?

Consider: N-Acetyl Cysteine For The Liver & More

Or if you prefer a purely dietary approach, then: How To Unfatty A Fatty Liver

Take care!

It’s not just the famous “brain-eating” amoeba, but yes, it is also that one too:

Naegleria fowleri et al.

First, let’s address the most dangerous species: Naegleria fowleri, often called the brain-eating amoeba, can cause a nearly always fatal brain infection when contaminated water enters the nose during activities such as swimming.

You may remember it from such outbreaks as:

Texas residents warned of tap water tainted with brain-eating microbe

Probably few people are swimming in tap water, but:

• Some will rinse their nose, as with a neti pot
• Humans have an unusual layout of internal cavities that allows connection between the nose and throat, so drinking it can still be an issue.
  • You may be wondering whether amoeba can walk up the walls. The answer comes in two parts:
    • Yes, though how easily will depend on the state of your mucus membrane
    • If you lie down, then that “climb” is now a sideways walk

But my water is clean, right?

Mayyyyyybe, but it’s best to not count on it, especially not anymore. This is because climate change, aging water infrastructure, and patchy monitoring are all enabling heat-tolerant amoebae to spread into new regions and persist and even thrive in modern water systems.

It’s not just “heat tolerance”, though: these free-living amoebae can survive high temperatures, high pH, and chlorine concentrations that kill most microbes, making standard water treatment methods less effective.

However, it gets worse: amoebae can shelter bacteria and viruses inside their cells, protecting these pathogens from disinfection and contributing not only to their spread, but also to antibiotic resistance as well.

This method of hardy amoebae smuggling bacteria and viruses into your body is called the “Trojan horse effect”, and you can read about it here:

The rising threat of amoebae: a global public health challenge

…and, for that matter:

Scientists call for urgent action as dangerous amoebas spread globally

What’s the best way to be safe?

Filtering water that you get from some other source (e.g. the water supply that your local authority has done its best to purify and probably missed these amoebae) is, generally speaking, good.

Provided you change the filter regularly, of course.

Otherwise, after overusing a filter, at best it won’t be working, and at worst it’ll be adding in bacteria that have multiplied in the filter over however long you left it there.

You may be wondering: can water filters remove microplastics, and can they remove minerals?

The answer in both cases is: sometimes.

• For microplastics it depends on the filter size and the microplastic size (see our previous article for details on that).
• For minerals, it depends on the filter type. Check out:

The H₂O Chronicles | 5 Water Filters That Remove Minerals

One other thing to think about: while most water filtration jugs are made of PFAS-free BPA-free plastics for obvious reasons, for greater peace of mind, you might consider investing in a glass filtration jug, like this one ← this is just one example product on Amazon; by all means shop around and find one you like

What about distilling water, you may wonder?

Distilled water is in principle the safest water anywhere, because you know that you’ve removed any nasties, including brain-eating amoebae et al.

However, it’s also devoid of nutrients, because you also removed any minerals it contained. Indeed, if you use a still, you’ll be accustomed to the build-up of these minerals (generally simplified and referenced as “limescale”, but it’s a whole collection of minerals). Furthermore, that loss of nutrients can be more than just a “something good is missing”, because having removed certain ions, that water could now potentially strip minerals from your teeth. In practice, however, you’d probably have to swill it excessively to cause this damage.

Nevertheless, if you have the misfortune of living somewhere like Flint, Michigan, then a water still may be a fair necessity of life. In other places, it can simply be useful to have in case of emergency, of course.

Here’s an example product on Amazon if you’d like to invest in a water still for such cases.

PS: distilled water is also tasteless, and is generally considered bad, tastewise, for making tea and coffee.

Ultimately, the question is how safe you want to be, and what you’re willing to sacrifice to assure that safety.

What about bottled water, you ask?

Not only is it not routinely monitored for such contaminants, but also, there is the unfortunate matter of what else it puts in, see for example:

There are “forever chemicals” in our drinking water. Should standards change to protect our health?

Want to learn more?

Check out:

Water’s Counterintuitive Properties

Take care!