1. Increased risk of hypoglycemia when used with insulin
Apple cider vinegar has become a popular trend for blood sugar control in people with type 2 diabetes. This is partly due to research indicating that daily consumption of ACV can help lower fasting blood glucose levels. The effect may be due to several mechanisms, including delayed gastric emptying (when food passes from the stomach to the small intestine), increased insulin production, and a decrease in enzymes that break down carbohydrates. However, researchers note that more studies are needed.
Because of its possible blood sugar-lowering effects, taking apple cider vinegar with diabetes medications can cause your blood sugar to drop too low.
If you have diabetes, check with your healthcare team before adding apple cider vinegar to your diet.
2. Stomach problems, especially in people with gastroparesis
The purported appetite-regulating effects of apple cider vinegar are due to the fact that it can slow the rate at which food leaves the stomach.
While this is great if you’re trying to prolong feelings of fullness and consume fewer calories, it may not be as good for people with gastroparesis.
Gastroparesis is a disorder that affects the nerves and muscles of the stomach. This causes food to stay in the stomach for too long, causing digestive problems.
According to the Cleveland Clinic, gastroparesis affects about one-third of people with type 1 and type 2 diabetes. This happens when high blood sugar levels cause damage to the nerves and blood vessels, which can affect the muscles and nerves in the stomach.
If you have diabetes, consult your doctor before adding apple cider vinegar to your diabetes management plan. Working with your doctor to regularly monitor your blood glucose levels can ensure you’re doing it safely.
3. Esophageal burns
Because apple cider vinegar is so acidic, it can cause throat irritation. Drinking ACV without first diluting it in water can also burn the esophagus.
While it is unclear how common these episodes are, many experts, including Dr. Katz and Michelle JaelinA registered dietitian in Ontario, Canada, still recommends diluting apple cider vinegar in water before drinking it. “It is an acid and can damage the lining of the esophagus if given directly as an injection,” says Jaelin.
4. Interactions with other medications
Katz says taking apple cider vinegar can interfere with certain medications. Specifically, it could affect those taking diuretics, laxatives, or insulin. Laxatives and diuretics, such as water pills, can cause fluid loss, resulting in lower potassium levels. Taking them together with apple cider vinegar can cause potassium levels to drop too low.
It’s a good idea to talk to your doctor or pharmacist before taking apple cider vinegar, to make sure you’re safe.
5. Decreased potassium levels
Regular consumption of large amounts of apple cider vinegar can reduce potassium levels in the blood.
Low potassium levels can cause:
Weakness
Fatigue
Constipation
muscle cramps
Irregular heart rhythms (arrhythmias)
The potassium-lowering effects of ACV are especially concerning for people taking medications that also lower potassium, such as diuretics to treat high blood pressure. These people should avoid taking ACV.
6. Tooth erosion
“Vinegar is very acidic,” says Katz. “It can seriously damage tooth enamel.” Because of this, many experts are wary of apple cider vinegar, and advocates suggest diluting it with water rather than drinking it neat.
According to a review published in 2021, consuming more acidic foods and drinks increases the likelihood of tooth erosion or enamel demineralization. This weakens the teeth, making them more susceptible to stains, sensitivity, and cavities.
Eroded tooth enamel can also cause teeth to become more sensitive over time, according to Azzaro. She emphasizes the importance of consuming a diluted form of apple cider vinegar and also has another tip: “To protect your teeth, rinse your mouth with running water immediately afterward.”
7. Chemical burns on the skin
Some people apply apple cider vinegar directly to the skin as a toner. Many consider it a home remedy to clear up skin problems like acne and signs of aging.
But before you think about trying it as a secret weapon for clear skin, keep in mind that undiluted ACV carries a risk of irritation.
“It’s a rare but ultimately possible side effect whenever you apply undiluted apple cider vinegar to your skin,” he says. Nazanin Saedi, MDdermatologist and associate clinical professor at Thomas Jefferson University in Philadelphia.
For this reason, it is not recommended to apply it or any other highly acidic product to your face. “They’re too hard,” he says.
Instead, avoid the DIY route entirely and choose a toner that targets the specific problem you’re facing, like salicylic acid to treat breakouts.
The takeaway
Apple cider vinegar has potential health benefits, but it also carries risks of side effects.
Possible side effects of apple cider vinegar include low blood sugar, esophageal burns, skin irritation, and tooth erosion.
Consulting your doctor before trying apple cider vinegar and diluting it with water can help decrease the risk of side effects.
