stevia withdrawal symptoms

"Sugar is a substance that has been shown to release dopamine and opioids in the brain, both of which have addictive potential," says Ilene . Your Brain on Sugar 3 /19 Sugar fuels every cell in the brain. View abstract. Takasaki, M., Konoshima, T., Kozuka, M., Tokuda, H., Takayasu, J., Nishino, H., Miyakoshi, M., Mizutani, K., and Lee, K. H. Cancer preventive agents. We avoid using tertiary references. DOI: Hoebel BG, et al. J Med Assoc Thai. Symptoms of sugar withdrawal can be unpleasant and difficult to cope with. Stevia rebaudiana is the plant from which stevia is obtained.This plant belongs to the Asteraceae family and is native to South America, where it has been used as a food and medicine for hundreds of years. (2018). I couldn't bend my fingers - and bonus!- I had an interesting new rash all over my body The next day the rash has overtaken my body and face, but my anxiety was waning. Glucose is cleared from the bloodstream, and blood sugars drop, but no real sugar/glucose is provided to the body to compensate. The side effects of stevia include gastrointestinal issues, extremely low blood sugar levels, endocrine disruption, sore muscles, and numbness. J Ethnopharmacol 1991;33:257-622. A pilot study of repeated exposures in some normotensive and hypotensive individuals and in Type 1 and Type 2 diabetics. People who swear off diet sodas often experience withdrawal symptoms such as: Depression; Nausea; Tremors; Irritability; Anxiety; Diet Soda and increased risk for cardiovascular event: Diet soda heightens risk for stroke, heart attack, and vascular death. (2009). Developmental toxicity of steviol, a metabolite of stevioside, in the hamster. Taware, A. S., Mukadam, D. S., and Chavan, A. M. Antimicrobial Activity of Different Extracts of Callus and Tissue Cultured Plantlets of Stevia Rebaudiana (Bertoni). View abstract. 2005;8(5-6):269-276. doi:10.1080/10284150500485221, DiNicolantonio JJ, et al. Certain chemicals in stevia are commonly used as natural food sweeteners. Sugar withdrawal happens when you suddenly stop eating sugar after being used to eating it regularly, and you start to experience physical and mental symptoms, such as: Headaches Dizziness Nausea Fatigue Mood changes Concentration problems Irritability Anxiety Intense cravings Changes in sleeping patterns Chaturvedula, V. S. and Prakash, I. View abstract. View abstract. Does soy really affect breast cancer risk? Studies show having low levels of dopamine can lead to these disorders, even for short periods of time. FDA. 2019;11(12):3036. View abstract. U.S. Food and Drug Administration, December 17, 2008. The depressogenic potential of added dietary sugars. Video of the Day The Science Behind Stevia Stevia, not to be confused with Splenda, is a sugar substitute sweetener that comes from the plant Stevia rebaudiana, which is native to South America. D'Andrea Meira I, Romo TT, Pires do Prado HJ, Krger LT, Pires MEP, da Conceio PO. While you can get many brands of stevia at health food stores and online, you're likely to see products from large food companies on grocery store shelves, like Truvia and PureVia. View abstract. Some sugar substitutes also are sold on their own in packets or other containers. Remember to start slowly and speak to your doctor before you start exercising if you have any preexisting medical issues. It can have a bitter flavor or to some people, it can taste like menthol. Because many products sweetened with erythritol are also sweetened with asparatame, the side effects of the food in question are that more dangerous to your health. Read more here. Acute effects of brisk walking on sugary snack cravings in overweight people, affect and responses to a manipulated stress situation and to a sugary snack cue: A crossover study. Effect of Stevia rebaudiana on glucose tolerance in normal adult humans. 2005 - 2023 WebMD LLC, an Internet Brands company. Food Chem.Toxicol. Other sugar substitutes called sugar alcohols are not as sweet as sugar. It harms the intestinal wall, potentially causing leaky gut. Stevia is obtained from the leaves of the plant and is highly purified to produce the sweet, low-calorie all-natural sweetener used in various foods today. View abstract. Cutting added sugar from your diet may lead to physical and mental symptoms. Cutting added sugar from your diet may help protect against chronic disease development and boost your overall health. Clin Ther 2003;25:2797-808. Over all, for nonnutritive sweeteners, we lack evidence, but thats especially true for stevia, which has not been extensively studied, said Meghan Azad, assistant professor of pediatrics and child health at the University of Manitoba. The impact of sleep deprivation on food desire in the human brain. Select a condition to view a list of vitamins. We currently have no information for STEVIA overview. The main problem is sustaining a low-sugar diet. Br J Clin Pharmacol 2000;50:215-20. 2019; doi:10.1542/peds.2019-2765. J Agric Food Chem 2008;56:3777-84. Review/update the Sometimes people eat sugary foods when their bodies are actually craving liquid, so often simply drinking a glass of water can stop a sugar craving. American Heart Association. To provide you with the most relevant and helpful information, and understand which Some have no calories. Withdrawal symptoms. They also affect mood. A critical review of the genetic toxicity of steviol and steviol glycosides. Only the highly purified steviol glycosides made from stevia leaves are deemed safe. View abstract. View abstract. Sugar also triggers a release of dopamine, which is a neurotransmitter linked to cravings. People on a ketogenic diet consume less than 10% of their calories from carbohydrates per daywhich may be less than 20 grams of carbs. In general, it is safest to take in small amounts of sugar substitutes. It can serve to sweeten your morning coffee or your oatmeal. Stevia might have an effect like a water pill or "diuretic." Or you might stop drinking high-sugar soda and other sugary beverages and replace them with water or other low-sugar drinks. You'll be doing great on your diet then suddenly you have those cravings for sugar. Stevia sweeteners are purified extracts of one type of constituent, called steviol glycosides, found in the leaves of the stevia plant. OTHER NAME(S): Azucacaa, Caa-He-, Ca-A-Jhei, Ca-A-Yupi, Capim Do. View abstract. US Food and Drug Administration. Many sugar substitutes taste sweeter than sugar. According to a 2018 review, the most common foods associated with addictive symptoms are those high in added fats or added sugars. Some people find that their symptoms last from a few days to a couple of weeks. Here are 14 healthy sources, The Microbiome Diet is a new, trendy diet, touted to restore gut health and aid weight loss. Stamataki NS, Crooks B, Ahmed A, McLaughlin JT. Consuming sugars helped them build up body fat, which was essential for surviving periods of scarcity. And it's best to use sugar substitutes for a short time, or just every once in a while. (2013). Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. View abstract. Are there any downsides to the sweetener stevia? Acesulfame potassium (Sweet One, Sunett). It is important to talk to a healthcare provider before beginning a low-carb or ketogenic diet. The European Food Safety Authority and the World Health Organization both say these compounds are safe in the amounts typically used. 1 The alcohol withdrawal timeline varies, but symptoms may begin a few hours to a few days after you stop drinking. Some stevia products contain added sugar alcohols that may cause unpleasant symptoms in individuals that are very sensitive to the chemicals. Researchers are checking to see if sugar substitutes affect cravings for sweets, the way people feel hunger and how the body manages blood sugar. Stress and eating behaviors. Our website services, content, and products are for informational purposes only. Instead, get your sweet fix from something that contains fiber, like berries, oranges, or apples. For example, you might swap out sugary snacks for foods that are higher in proteins, fats, and whole grains. Additional information about high-intensity sweeteners permitted for use in food in the United States. https://www.uptodate.com/contents/search. Aspartame has long been a controversial food additive. "Other causes include stress, skipping meals, change in sleep, alcohol consumption, menstruation and certain foods like preservatives.". Stevia is a substitute for sugar which is derived from the leaves of the stevia plant and it tends to be 100 to 300 times sweeter than raw sugar. What Is Stevia? View abstract. Chan P, Tomlinson B, Chen YJ, et al. Symptoms of cutting added sugar from your diet, hsph.harvard.edu/nutritionsource/carbohydrates/added-sugar-in-the-diet, bioscience.org/2018/v23/af/4704/fulltext.htm, health.clevelandclinic.org/break-your-sugar-addiction-in-10-days-infographic/, ncbi.nlm.nih.gov/pmc/articles/PMC2892765/Trusted Source, ncbi.nlm.nih.gov/pmc/articles/PMC4214609/Trusted Source, A Simple 3-Step Plan to Stop Sugar Cravings, 13 Simple Ways to Stop Eating Lots of Sugar, The MIND Diet: A Detailed Guide for Beginners, Best Diet for Gout: What to Eat, What to Avoid, 14 Healthy Fats for the Keto Diet (Plus Some to Limit). Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. View abstract. Liauchonak I, et al. Mayo Clinic does not endorse companies or products. Influence of stevioside on hepatic glycogen levels in fasted rats. The Food and Drug Administration (FDA) considers stevia leaf extract safe for consumption, and it is unlikely to cause side effects in most people. Metabolism 2000;49:208-14. Regul Toxicol Pharmacol 2008;51:37-41. View abstract. Sugar cravings are one of the main reasons people have a hard time losing weight and eating healthy. Once ketosis begins, you may notice symptoms such as: Basically, ketosis feels like a mild flu. Dr. Azad was the lead author of a recent review of long-term use of nonnutritive sweeteners that concluded that they may not be helpful for weight loss and, in some studies, were associated with increased incidence of obesity, diabetes and heart disease. Lemus-Mondaca R, Vega-Galvez A, Zura-Bravo L, Ah-Hen K. Stevia rebaudiana Bertoni, source of a high-potency natural sweetener: A comprehensive review on the biochemical, nutritional and functional aspects. 2012;132(3):1121-1132. Studies dating back to the 1970s linked the artificial sweetener saccharin to bladder cancer in rats. Food Chem Toxicol 2008;46 Suppl 7:S75-82. Each small step will build upon the last, taking you into a healthier tomorrow. But limit or cut out sugar substitutes: Dietary guidelines for Americans say adults shouldn't give sugar substitutes to children under 2 years old. CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. DOI: Westerterp-Plantenga MS, et al. National Cancer Institute. Overdosing with stevia may lead to tingling or numbness in your hands and feet, similar to the feeling of neuropathy, as well as a temporary loss in motor control. The symptoms and their severity will depend on how much added sugar you were taking in through sweetened foods and beverages. Serotonin: What It Is, How to Increase It, and Can You Have Too Much? Food Chem Toxicol 2008;46 Suppl 7:S83-91. In one study, when given a choice between cocaine and sugar, cocaine-addicted rats primarily chose the sugar. Sugar addiction: Is it real? J Ethnopharmacol 2021;265:113188. Endorphins make you feel better while you are eating, but they dont stick around for long. Abdel-Aal RA, Abdel-Rahman MS, Al Bayoumi S, Ali LA. Asparatame causes such side effects as anxiety, depression, short-term memory loss, fibromyalgia, weight gain, fatigue, brain tumors and more. Its your overall diet quality that matters most. Front Neurosci. Mild tremors have been linked to stress and blood sugar drops, two things that quitting sugar provide in spades. But be aware of how sugar substitutes affect your food and drink choices. Verywell Mind's content is for informational and educational purposes only. Brain zaps also sometimes referred to as brain shivers, brain shocks or head shocks are described as being one of the most unbearable withdrawal symptoms when stopping certain depression and anxiety medications. Changes in sleep patterns Depressed mood Difficulty concentrating Dizziness or lightheadedness Fatigue Intense cravings for something sweet Intense cravings for other carbohydrates, like chips or pasta Irritability Nausea These symptoms can be unpleasant, and cravings can sometimes lead to binge-eating behaviors. Almost everyone likes a sugary snack. View abstract. The MIND diet was designed specifically to keep your brain healthy. Available at: https://www.cfsan.fda.gov/~rdb/opa-gn08.html. View abstract. And it may also interact with drugs like lithium. These ingredients may get your tastebuds used to sweetness. Nausea. (2013). View abstract. In the United States, the Food and Drug Administration (FDA) allows the following sugar substitutes to be used: Other countries, such as those in the European Union, have more sugar substitute options than does the United States. Though the super sweet non-nutritive (meaning no-calorie) sugar substitute has become very popular in recent years, some people wonder if it can be the cause of their headaches. Ketogenic diet and epilepsy: What we know so far. They taste sweet like sugar but have fewer calories. A narrative review, American Heart Association Diet and Lifestyle Recommendations, Ketogenic diet and epilepsy: What we know so far, The impact of sleep deprivation on food desire in the human brain, Acute effects of brisk walking on sugary snack cravings in overweight people, affect and responses to a manipulated stress situation and to a sugary snack cue: a crossover study. But if you often have foods and drinks with lots of added sugar, the empty calories can add up. View abstract. doi:10.1016/j.clnu.2009.12.001. If your goal is to transition to a ketogenic diet, then you will have to give your body time to adjust. (2017). As your body adapts to a low added sugar diet over time and your added sugar intake becomes less frequent, the less intense your symptoms and cravings for sugar are likely to be. If you are trying to reduce your sugar intake or cut sugar out of your diet, there are some steps you can take to help cope with sugar withdrawal symptoms. Benton D. The plausibility of sugar addiction and its role in obesity and eating disorders. A narrative review. Always consult with your healthcare provider before transitioning to a ketogenic diet. DOI: Reis DJ, et al. Avicenna J Phytomed. Research has found that even short bursts of brisk exercise can help reduce sugar cravings. Sugar also appears to have a calming effect on stress hormones, which contributes to your desire for sugar when feeling stressed. Major health and food safety organizations generally regard stevia, a sweetener made from a plant native to South America, as safe. Chronic administration of aqueous extract of Stevia rebaudiana in rats: renal effects. Geuns JM. Let's explore some of these symptoms, the sugar withdrawal timeline, why giving up sugar is so hard, and what you can do to feel better until sugar withdrawal symptoms fade. Journal of Applied Science Research 2010;6(7):883-887. You may experience cravings and other side effects that tend to go away after a time. 2013;4:2259. doi:10.1038/ncomms3259, Ledochowski L, Ruedl G, Taylor AH, Kopp M. Acute effects of brisk walking on sugary snack cravings in overweight people, affect and responses to a manipulated stress situation and to a sugary snack cue: a crossover study. Read more: Known Side Effects of Stevia "Headaches can be caused by various triggers, and often this is specific to the individual," says Dr. Jann. Sugar can also cause the release of endogenous opioids in the brain, which leads to a rush that may cause future cravings. Many focus on how the gut and brain communicate. Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. (2016). Some research on long-term, daily use of artificial sweeteners suggests a link to a higher risk of stroke, heart disease and death overall. She and her co-authors, however, found no long-term studies of stevia in particular to include in that review. Foods and drinks with aspartame can lead to serious health problems. The FDA and food safety agencies in other countries also suggest how much of a sugar substitute you can safely have each day. October 4, 2021. We Recommend Health Aspartame & Stomach Cramps Nutrition Is Crystal Light Bad for You? The plausibility of sugar addiction and its role in obesity and eating disorders. https://professional.diabetes.org/sites/professional.diabetes.org/files/pel/source/sugar_substitutes.pdf. Brain fog: Finding it hard to concentrate and feeling like you're in a fog is another common sugar withdrawal symptom. Inhalation of vapor from black pepper extract has been shown to reduce smoking withdrawal symptoms, while simultaneously bestowing a mental "pick-me-up" that may achieve many similar effects as nicotine. I wasn't as swollen. How sweet it is: All about sugar substitutes. Tomita T, Sato N, Arai T, et al. How Long Do Sugar Withdrawal Symptoms Last? Monitor your blood sugar closely. The amount of sugar alcohol that causes these symptoms varies from person to person. Research suggests that certain artificial sweeteners may lead to metabolic changes that may increase cravings, food intake, and weight gain. Rios-Leyvraz M, et al. 2023 Dotdash Media, Inc. All rights reserved. Physical symptoms may include the following issues: Headaches. Here are some tips to help you beat the side effects and avoid or at least limit some of the symptoms related to cutting sugar out of your diet. If you have a bowel disease. If you are trying to cut back on sugar in your diet, it can be helpful to understand what kinds of symptoms you might experience and how long they will last. That's the category stevia is in. Self-medication with sucrose. Stevia contains chemicals that are 200-300 times sweeter than sucrose sugar. Effect of stevia aqueous extract on the antidiabetic activity of saxagliptin in diabetic rats. Phytother Res 2006;20:732-6. Jeppesen, P. B., Gregersen, S., Rolfsen, S. E., Jepsen, M., Colombo, M., Agger, A., Xiao, J., Kruhoffer, M., Orntoft, T., and Hermansen, K. Antihyperglycemic and blood pressure-reducing effects of stevioside in the diabetic Goto-Kakizaki rat. Whole foods, such as fruits and vegetables, usually have the best mix of nutrients for the body. Ajami M, Seyfi M, Abdollah Pouri Hosseini F, et al. Gordon EL, et al. This includes table sugar, high-fructose corn syrup, and white flour. The FDA allows product-makers to use sugar alcohols, such as sorbitol and xylitol, too. These are your bodys natural opioids. Effect of calcium and verapamil on renal function of rats during treatment with stevioside. View abstract. information is beneficial, we may combine your email and website usage information with View abstract. Content is reviewed before publication and upon substantial updates. Metabolism 2004;53:101-7. Drink lots of water. You can learn more about how we ensure our content is accurate and current by reading our. Bactericidal activity of a fermented hot-water extract from Stevia rebaudiana Bertoni towards enterohemorrhagic Escherichia coli O157:H7 and other food-borne pathogenic bacteria. Development of rebiana, a natural, non-caloric sweetener. You may be forgetful and challenging to stay on task. Acute responses of stevia and d-tagatose intake on metabolic parameters and appetite/satiety in insulin resistance. All rights reserved. If youre used to regularly eating sugary foods like cake, ice cream, sweetened breakfast cereal, candy, and cookies and regularly drink sugar-sweetened beverages, it may take time to reduce your reliance on added sugar. So very little is needed to sweeten foods and drinks. (2016). American Diabetes Association. You can make your own bitters or choose bitter foods, such as coffee, arugula, or broccoli raab (rapini). View abstract. CFSAN/Office of Food Additive Safety. If you are a Mayo Clinic patient, this could My nose stopped running. View abstract. 10-22-2003;51(22):6618-6622. DOI: Bray GA. (2016). Study participants consumed 20 milliliters of stevia extract daily for one month. The nature and severity of these symptoms vary from one person to the next. Other possible physical withdrawal symptoms include: Giving up sugar can feel unpleasant, both mentally and physically. Yasukawa, K., Kitanaka, S., and Seo, S. Inhibitory effect of stevioside on tumor promotion by 12-O-tetradecanoylphorbol-13-acetate in two-stage carcinogenesis in mouse skin. If you are following a low-carb or keto diet for weight loss, consider altering your approach. Phenylketonuria (PKU). (2012). Sugar also causes a release of dopamine, which plays a major role in habit formation. And that can make drinking enough water a challenge. In general, artificial sweeteners are safe in limited amounts for healthy people, including pregnant people. D'Agostino, M., De Simone, F., Pizza, C., and Aquino, R. [Sterols in Stevia rebaudiana Bertoni]. That said, reducing added sugar consumption can have substantial health benefits. To transition to a low-carb diet and put an end to the keto flu, all you have to do is eat some fruit. Taking a short walk, talking to a friend, and reading a book are a few simple ways to relax. While doing so isnt always easy, the benefits are worth it, as added sugar has been proven to have negative effects on your body. Other symptoms that may occur during the adderall withdrawal process include lethargy, sleepiness, increased hunger, depression, problems concentrating, and increased cravings to use the drug. Stevioside. The Experts Agree: What You Eat Can Directly Impact Stress and Anxiety, Adderall Withdrawal: Symptoms, Timeline, and Treatment, The Connection Between Mental Health and Physical Health, Feel Good Foods: The Diet-Brain Connection. Impact of sugar on the body, brain, and behavior. However, some products containing stevia also include sugar alcohols like erythritol, which can cause digestive complaints if consumed in large amounts. 2018;148(3):251253. View abstract. other information we have about you. It's best known as a natural sweetener. Artificial sweeteners and other sugar substitutes. Research suggests that eating protein can promote feelings of fullness, which can help you manage food cravings. Giving up or reducing sugar can be difficult, especially if your diet was high in added sugar, so go easy on yourself. This is considerably more than the recommended maximum, which is 6 teaspoons (about 24 grams) for females and 9 teaspoons (about 36 grams) for males. So try to cut back if you use them a few times a day. Nutr Neurosci. Abdominal cramps. There are sugars in many of the healthy foods you eat, including fruit, bread, and dairy products. 000252. Reducing sugar in your diet can result in a number of symptoms, both physical and mental. Read our. DOI: Wiss DA, et al. View abstract. Nat.Prod Commun 2011;6(2):175-178. Reducing your added sugar intake is a great decision to make for a healthier lifestyle. Keeping a headache diary and reviewing it with your doctor can help pinpoint the root cause of your headaches and show you what to avoid and which natural remedies for headaches might work for you. By removing aspartame, a dopamine-stimulating additive, you may experience mood swings from happiness to sadness. Its uncertain, though, whether using calorie-free sweeteners like stevia can reduce caloric intake. And if used in moderation, artificial sweeteners can be part of a healthy diet. Jeppesen PB, Gregersen S, Poulsen CR, Hermansen K. Stevioside acts directly on pancreatic beta cells to secrete insulin: actions independent of cyclic adenosine monophosphate and adenosine triphosphate-sensitive K+-channel activity. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study. A snack labeled low sugar or no sugar may not be the most nutritious choice. Two minor diterpene glycosides from the leaves of Stevia rebaudiana. If you replace added sugar with sugar substitutes, it could lower your risk of getting tooth decay and cavities. But it's not clear whether sugar substitutes can help people manage their weight over the long term. DOI: Apolzan JW, et al. When eaten in large quantities, Splenda may have a laxative effect. If going sugar-free for three weeks is going to make you binge next month, try a less drastic plan. Signs and symptoms of withdrawal include: These kinds of changes in brain chemistry lead to dependence, withdrawal, and addiction. 2020;150(5):1126-1134. J Agric.Food Chem 2-8-2006;54(3):785-789. Some doctors fear that restricting carbs could contribute to bone loss and several chronic diseases. Taking stevia along with medications that lower blood pressure might cause blood pressure to go too low. Food cravings mediate the relationship between chronic stress and body mass index. Replacing drinks high in sugar, such as soda and energy drinks, with water can help reduce your added sugar and overall calorie intake. Accessed Nov. 14, 2022. High fiber foods also contribute to healthy blood sugar regulation. doi:10.4103/ijmr.IJMR_1666_18. WebMD does not provide medical advice, diagnosis or treatment. The body is programmed to release insulin when your mouth tastes "sweetness," so if there is no sugar for the insulin to metabolize, I'd worry that it would remain in the blood stream and potentially lead to hypoglycemia, which comes with side effects of anxiety and hunger. This conclusion is based on studies mostly industry funded in bacteria and rodents that generally show that stevia doesnt cause damage to DNA or cancer, as well as several human studies that found no effect on blood pressure or blood glucose. The Center for Science in the Public Interest, a food advocacy group that has often been critical of sugar substitutes, initially raised concerns about stevia sweeteners when they came onto the market in 2008, saying the Food and Drug Administration should have required more testing. For this reason, children and teenagers should not do low-carb diets. Drug Chem Toxicol 1998;21:207-22. Stevia might lower blood pressure. 5. How to Overcome Smoking Urges in Just 5 Minutes, Daily Tips for a Healthy Mind to Your Inbox, Sugar addiction: From evolution to revolution, Implications of an animal model of sugar addiction, withdrawal and relapse for human health, Sugar addiction: is it real? Accessed Nov. 11, 2022. Hubler MO, Bracht A, Kelmer-Bracht AM. Q. If the tremors are hitting you hard, it probably means that your blood sugar is particularly low. How the body reacts to giving up sugar is different for everyone. Structures of the novel diterpene glycosides from Stevia rebaudiana. Agency Response Letter: GRAS Notice No. Night sweats. Stevia is a natural sweetener that comes from the leaves of the Stevia plant. Barriocanal LA, Palacios M, Benitez G, et al. This could increase how much lithium is in the body and result in serious side effects. 2019;13:5. doi:10.3389/fnins.2019.00005, Greer SM, Goldstein AN, Walker MP. Mutagenesis 1996;11:573-9. But rest assured,. But these also are forms of added sugar. Added sugar can play a part in weight gain. U.S. Food and Drug Administration.

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stevia withdrawal symptoms