7 Side Effects of Apple Cider Vinegar You Should Be Aware of

Apple cider is an age-old staple that has been used as a health remedy.

Recently, it has gained popularity due to some of its health benefits, such as improving blood sugar levels and aiding weight loss.

However, while it may help some, it can also have negative side effects.

This article reviews some of the potential downsides to apple cider vinegar.

Additionally, this article gives an overview of how to use apple cider vinegar safely.

What Is Apple Cider Vinegar?

Apple cider vinegar is made by fermenting apple juice or cider twice over. 

Yeast combines with the natural sugar in the apples, which begins the fermentation process. 

The first process turns the cider into alcohol, and the second process uses helpful bacteria to turn the alcohol into acetic acid. 

This process is similar to other types of vinegar.

Apple cider vinegar contains 5-6% acetic acid, making it a “weak acid.” 

Do not let this term fool you, as the acidic nature of this vinegar can cause damage.

This household staple is often used in cleaning, cooking, baking, and as a food preservative.

7 Side Effects of Apple Cider Vinegar

1. Erosion of Tooth Enamel

Due to the acidic nature of apple cider vinegar, when taken excessively and in an undiluted form, it may cause damage to your tooth enamel and lead to cavities. 

Always dilute apple cider vinegar and rinse your mouth with a large glass of water or brush your teeth after taking it.

2. Low Potassium Levels

Potassium is essential for one’s bone and heart health, and low potassium can also lead to other health issues such as osteoporosis. 

According to Harvard doctors, ACV has been reported to worsen already low potassium levels. 

This is especially important if you take diuretic medications for high blood pressure, which also lower potassium levels (1).

When potassium levels get too low, it can cause weakening of the muscles or paralysis. 

If you experience these symptoms, contact your doctor right away.

3. Digestive Issues

Some people believe that taking this vinegar will help with digestion, but can it really help your digestive system? 

In fact, it may actually cause problems with digestion. 

Drinking apple cider vinegar, especially when undiluted, may cause nausea and indigestion. 

ACV has been shown to delay gastric emptying.

Due to the acid in vinegar, it could also cause irritation in the esophagus if taken excessively or in an undiluted form. 

If you suffer from gastroesophageal reflux or GERD, talk with your doctor before taking apple cider vinegar. (2)

4. Uncomfortable Bloating

One study actually found that apple cider vinegar may delay or impair gastric emptying. 

So while this may explain why people enjoy a feeling of fullness for longer, it wouldn’t necessarily help with other issues with digestion. (3)

This may also cause problems in those with gastroparesis, a common condition of diabetics. 

Gastroparesis is marked by a malfunction in the nerves in the stomach, resulting in food staying in the stomach for longer than normal. 

Symptoms include bloating, nausea, and heartburn.

Another study found that drinking 2 Tbsp (30 mL) of apple cider vinegar diluted in a glass of water resulted in an increase in the time that food stayed in the stomach (3).

5. Chemical Burn on the Skin

Some people believe that using ACV on the skin as a toner may help fight bacteria that cause acne or breakouts. 

But due to the acid in it, it can also irritate the skin and may even result in burns.

In fact, the National Capital Poison Center notes several cases of people reporting skin irritation and skin burns after applying compresses containing vinegar to the skin. (4)

Additionally, there are reports of people using ACV as a means to remove moles that result in chemical burns on the skin. (5)

In short, if you are looking to improve your skin’s condition, it is best to consult with a certified dermatologist for the best products for your skin type.

6. Throat Burn

Many people believe in using apple cider vinegar as a home remedy for sore throat. 

Warm beverages and gargling solutions containing ACV are thought to help with the pain of a sore throat. 

However, there is no research to back up this usage with evidence.

In fact, vinegar may cause more harm than good to a sore throat.

The acid in vinegar may lead to irritation and esophageal burns, leading to even more throat pain and issues with swallowing. 

One study noted that a teen using an ACV beverage experienced corrosive damage to their throat (6).

7. Medication Interactions

Because ACV can lower your potassium levels and blood sugar levels, it can interact with certain medications. 

Some of the purported health benefits of vinegar may increase insulin sensitivity and cause dangerously low blood sugar levels if you are not careful. 

If you take a diuretic or “water pill” for high blood pressure, or if you take a prescription for diabetes, be careful about your apple cider vinegar consumption.

As always, pay careful attention to your medications when taking a new supplement or treatment. 

ACV has been shown to interact with diuretics, blood thinners, laxatives, and medications that you may take for diabetes and heart disease. (7)

What Are the Side Effects of Drinking Apple Cider Vinegar Everyday?

Using apple cider vinegar in food like salad dressings or sauces is likely safe. 

And it is possibly safe for adults to take specific doses for short periods of time. 

However, due to the concerns listed above, it might be unsafe if taken in large doses for long periods of time, or applied to the skin.

How Much Apple Cider Vinegar Is Too Much?

There is no standard or recommended dosage of ACV through supplements, capsules, or gummies. 

Using ACV in foods like sauces, marinades, and salad dressings is safe. 

But taking more than 2 tablespoons (15-30 mL) daily, especially if not diluted, is discouraged.

Who Should Not Drink Apple Cider Vinegar?

If you suffer from chronic heartburn, acid reflux, GERD, or take medication for blood pressure or diabetes, you should not take large amounts of apple cider vinegar. 

Additionally, if you have been diagnosed with gastroparesis or suffer from indigestion or bloating, it is not recommended to take ACV regularly.

How Much Apple Cider Vinegar Should You Drink?

Drinking straight ACV is not recommended. 

If you choose to make a beverage with ACV, remember to dilute it in a glass of water. 

It is common for people to stir 1-2 teaspoons or 1 – 2 tablespoons (15–30 mL) of vinegar into 8 ounces of water or tea.

How to Drink Apple Cider Vinegar Safely

Drinking straight ACV is not recommended.

Since this ingredient is used in so many recipes, it is now recommended that you simply include this in your everyday cooking. 

For example, ACV makes a wonderful salad dressing or can be stirred into other sauces.

If taking it for health reasons, it is probably best to use an unfiltered apple cider vinegar that contains the “mother” from the fermentation process. 

Bragg’s is a popular brand that offers this, and can easily be found in many supermarkets and grocery stores now.

It’s always a good idea to consult with your doctor or pharmacist about any potential interactions of ACV supplements with other medications you may be taking.

Final Thoughts

While there are several ways to enjoy the health benefits of apple cider vinegar, it should be used in moderation. 

This staple may help with some chronic conditions, but it should not be used as a natural remedy for skin or sore throat. 

References:

1. Schmerlin R. Apple cider vinegar diet: Does it really work? Harvard Health Blog. October 2020. https://www.health.harvard.edu/blog/apple-cider-vinegar-diet-does-it-really-work-2018042513703
2. Darzi J, et al. Influence of the tolerability of vinegar as an oral source of short-chain fatty acids on appetite control and food intake. International Journal of Obesity. 2014: 38; 675-681.
3. Hlebowicz J, Darwiche G, Bjorgell O, et al. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterology. 2007; 7 (46).
4. May M. Vinegar: Not just for salad. National Capital Poison Center. Accessed Jun 8, 2021. https://www.poison.org/articles/vinegar-164
5. Feldstein S, Afshar M, Krakowski A. Chemical Bum from Vinegar Following an Internet-based Protocol for Self-removal of Nevi. J Clin Aesthet Dermatol. 2015 Jun; 8(6): 50.
6. Chang J, Han SE, Paik SS, Kim YJ. Corrosive esophageal injury due to a commercial vinegar beverage in an adolescent. Clin Endosc. 2019 Aug;2019:ce.2019.066. doi:10.5946/ce.2019.066
7. Biswal B. Drug-excipient interaction study for apple cider vinegar with 20 potential excipients using modern analytical techniques. Asian J Pharma. 2016;2016:107.