The FDA has approved only highly purified steviol glycosides from Stevia rebaudiana leaves as safe to use. Products that are considered safe have words on their ingredient list, such as stevia extract. Using stevia as a sugar substitute can reduce calories in foods and drinks, but it can also have some adverse effects. Possible side effects include nausea, bloating, low blood pressure, and hormonal disorders. Because the FDA has not approved raw stevia extracts and stevia leaves as food additives, companies cannot import them into the United States for use as sweeteners.
In some countries, stevia supplements and extracts are increasingly being discovered to contain counterfeit ingredients, primarily artificial sweeteners that are linked to known health risks. Stevia can also interact with certain medications, so it's important to discuss stevia with a doctor before consuming or buying the product. The World Health Organization has established the acceptable daily intake (ADI) of steviol at 4 milligrams (mg) per kilogram of body weight, or 12 mg of stevia extract per kg of body weight. Overall, pure stevia extract is considered safe for most people when used in moderation. However, it is important to be aware of potential side effects and interactions with medications. It is also important to check the ingredients list on products that contain stevia extract to ensure that they are safe.