Apple cider vinegar effects

7 Side Effects of Too Much Apple Cider Vinegar

Unfortunately, apple cider vinegar has been reported to cause some side effects.

This is particularly true in large doses.

Although small amounts are generally fine and healthy, taking too much can be harmful and even dangerous.

1. Delayed Stomach Emptying

Apple cider vinegar helps prevent blood sugar spikes by reducing the rate at which food leaves the stomach and enters the lower digestive tract. This slows down its absorption into the bloodstream (9).

However, this effect may worsen symptoms of gastroparesis, a common condition in people with type 1 diabetes.

In gastroparesis, the nerves in the stomach don’t work properly, so food stays in the stomach too long and is not emptied at a normal rate.

Symptoms of gastroparesis include heartburn, bloating and nausea. For type 1 diabetics who have gastroparesis, timing insulin with meals is very challenging because it’s hard to predict how long it will take food to be digested and absorbed.

One controlled study looked at 10 patients with type 1 diabetes and gastroparesis.

Drinking water with 2 tablespoons (30 ml) of apple cider vinegar significantly increased the amount of time that food stayed in the stomach, compared to drinking plain water (10).

Bottom Line: Apple cider vinegar has been shown to delay the rate at which food leaves the stomach. This may worsen symptoms of gastroparesis and make blood sugar control more difficult for people with type 1 diabetes.

2. Digestive Side Effects

Apple cider vinegar may cause unpleasant digestive symptoms in some people.

Human and animal studies have found that apple cider vinegar and acetic acid may decrease appetite and promote feelings of fullness, leading to a natural reduction in calorie intake (11, 12, 13).

However, one controlled study suggests that in some cases, appetite and food intake may decrease due to indigestion.

The people who consumed a drink containing 25 grams (0.88 oz) of apple cider vinegar reported less appetite but also significantly greater feelings of nausea, especially when the vinegar was part of an unpleasant-tasting drink (14).

Bottom Line: Apple cider vinegar may help reduce appetite, but may also cause feelings of nausea, particularly when consumed as part of a drink with bad flavor.

3. Low Potassium Levels and Bone Loss

There are no controlled studies on apple cider vinegar’s effects on blood potassium levels and bone health at this time.

However, there is one case report of low blood potassium and bone loss that was attributed to large doses of apple cider vinegar taken over a long period of time.

A 28-year-old woman consumed 8 oz (250 ml) of apple cider vinegar diluted in water on a daily basis for six years.

She was admitted to the hospital with low potassium levels and other abnormalities in blood chemistry (15).

What’s more, the woman was diagnosed with osteoporosis, a condition of brittle bones that is rarely seen in young people.

Doctors who treated the woman believe the large daily doses of apple cider vinegar led to minerals being leached from her bones to buffer the acidity of her blood.

They also noted that high acid levels can reduce the formation of new bone.

Of course, the amount of apple cider vinegar in this case was much more than most people would consume in a single day — plus, she did this every day for many years.

Bottom Line: There is one case report of low potassium levels and osteoporosis likely caused by drinking too much apple cider vinegar.

4. Erosion of Tooth Enamel

Acidic foods and beverages have been shown to damage tooth enamel (16).

Soft drinks and fruit juices have been more widely studied, but some research shows the acetic acid in vinegar may also damage tooth enamel.

In one lab study, enamel from wisdom teeth was immersed in different vinegars with pH levels ranging from 2.7–3.95. The vinegars led to a 1–20% loss of minerals from the teeth after four hours (17).

Importantly, this study was done in a lab and not in the mouth, where saliva helps buffer acidity. Nevertheless, there’s some evidence that large amounts of vinegar may cause dental erosion.

A case study also concluded that a 15-year-old girl’s severe dental decay was caused by consuming one cup (237 ml) of undiluted apple cider vinegar per day as a weight loss aid (18).

Bottom Line: The acetic acid in vinegar may weaken dental enamel and lead to loss of minerals and tooth decay.

5. Throat Burns

Apple cider vinegar has the potential to cause esophageal (throat) burns.

A review of harmful liquids accidentally swallowed by children found acetic acid from vinegar was the most common acid that caused throat burns.

Researchers recommended vinegar be considered a “potent caustic substance” and kept in childproof containers (19).

There are no published cases of throat burns from apple cider vinegar itself.

However, one case report found that an apple cider vinegar tablet caused burns after becoming lodged in a woman’s throat. The woman said she experienced pain and difficulty swallowing for six months after the incident (20).

Bottom Line: The acetic acid in apple cider vinegar has caused throat burns in children. One woman experienced throat burns after an apple cider vinegar tablet became lodged in her esophagus.

6. Skin Burns

Due to its strongly acidic nature, apple cider vinegar may also cause burns when applied to the skin.

In one case, a 14-year-old girl developed erosions on her nose after applying several drops of apple cider vinegar to remove two moles, based on a protocol she’d seen on the internet (21).

In another, a 6-year-old boy with multiple health problems developed leg burns after his mother treated his leg infection with apple cider vinegar (22).

There are also several anecdotal reports online of burns caused by applying apple cider vinegar to the skin.

Bottom Line: There have been reports of skin burns occurring in response to treating moles and infections with apple cider vinegar.

7. Drug Interactions

A few medications may interact with apple cider vinegar:

  • Diabetes medication: People who take insulin or insulin-stimulating medications and vinegar may experience dangerously low blood sugar or potassium levels.
  • Digoxin (Lanoxin): This medication lowers your blood potassium levels. Taking it in combination with apple cider vinegar could lower potassium too much.
  • Certain diuretic drugs: Some diuretic medications cause the body to excrete potassium. To prevent potassium levels from dropping too low, these drugs shouldn’t be consumed with large amounts of vinegar.

Bottom Line: Some medications may interact with apple cider vinegar, including insulin, digoxin and certain diuretics.

Apple Cider Vinegar Risks and Side Effects

Because of its high acidity, drinking a lot of apple cider vinegar can damage your teeth, hurt your throat, and upset your stomach. Also:

  • Though some studies have been promising, there’s still little to prove that drinking apple cider vinegar helps you lose weight.
  • It may also cause your potassium levels to drop too low. Your muscles and nerves need that nutrient to work the way they should.
  • Another study of people with type 1 diabetes found that apple cider vinegar slows the rate food and liquids move out of your stomach to your intestines. Slower digestion makes it harder to control your blood sugar level.
  • It might cause some medications to not work as well. These include diabetes and heart disease drugs as well as diuretics (medicines that help your body get rid of water and salt) and laxatives.
  • And of course, its strong taste might not be for everyone.

In short, apple cider vinegar probably won’t hurt you. You can try it because it’s calorie-free, adds lots of flavor to food, and has health benefits. But it isn’t a miracle cure.

It turns out you can drink too much apple cider vinegar. Here’s what you should know.

  • Apple cider vinegar is often thought of as a miracle cure-all for things from weight loss to lowering blood sugar.
  • But too much apple cider vinegar can cause weakened tooth enamel, increased acid reflux, and nausea.
  • It can also interfere with certain medications.
  • To prevent these side effects, it’s best to consume apple cider vinegar only when it’s diluted and with other food.

Apple cider vinegar (ACV) is everywhere. It’s in celebrity diets, fitness hacks, and even in hair-care products. Because of this, you may think that one simply cannot consume enough apple cider vinegar.

But this isn’t exactly true. Although apple cider vinegar does have many potential health benefits, from lowering cholesterol to clearing up acne, it is possible to consume too much of it.

INSIDER talked with Bonnie Taub-Dix, registered dietitian nutritionist, creator of, and author of “Read it Before You Eat It — Taking You From Label To Table,” to find out what the limit is on ACV consumption.

“I think like a lot of other foods, held in a lot higher standard than it probably should be,” Taub-Dix told INSIDER. “It is tasty, and it’s something you can use in cooking, but it all depends on how you tolerate it.”

Taub-Dix said it can sometimes help with certain things, like killing harmful bacteria, regulating blood sugar, and assisting with weight loss (especially if you use it as a substitute for heavier foods). But she also said there are some things to look out for when drinking ACV.

Because apple cider vinegar is an acid, it can have a corrosive effect on the teeth

Like all acids, ACV can lead to damaged tooth enamel. Jeff J Mitchell/Getty Images

Too much apple cider vinegar is not your smile’s best friend, particularly if it’s undiluted.

“Where could be a problem is your teeth. Because it is a vinegar, it can affect the enamel on your teeth,” Taub-Dix said.

Weakened tooth enamel, in turn, can make you more susceptible to tooth decay, cavities, and oral sensitivity, according to Pittsburgh Dental Excellence Center.

The vinegar could also exacerbate nausea and cause an acidic burning feeling

“It is an acid,” Taub-Dix told INSIDER. “So if you’re having it on an empty stomach, that could make you feel more of an acidic burning feeling.”

Some people take ACV as a potential cure for acid reflux. But, according to Harvard Health Publishing, there is no research published in medical journals that indicates it can help with reflux. In fact, a study published in 2014 found that use of apple cider vinegar as a natural appetite suppressant caused “significantly higher nausea” in people who consumed ACV than those who did not.

It’s also possible that too much ACV could cause throat irritation.

It might also interfere with your medication

It’s best to talk to your doctor if you’re taking medication and drinking a lot of ACV. Lucas Jackson/Reuters

According to Healthline, too much apple cider vinegar can also interfere with certain medications. The medications to pay the closest attention to are diabetes medications, blood potassium-lowering drugs, and some diuretic drugs. In any case, it can’t hurt to ask your doctor if there’s anything you should try not to eat too much of while taking a kind of medication.

If you drink ACV, dilute it first and consume it with a meal

“If you do want to try having to see if it has any effect on you, try having it with a meal so it doesn’t have that acidic effect of sitting in your stomach alone with the other stomach acids in there,” Taub-Dix said.

Basically? It’s hard to go wrong with small, diluted amounts of apple cider vinegar, especially if it’s combined with other food. In fact, according to Healthline, a typical dose of ACV is 1 to 2 tablespoons mixed with water and taken before or after meals. But if you’re treating ACV like medicine and consuming much more than the recommended amount, you might have some undesirable consequences.

Apple Cider Vinegar for Digestion. What’s the Deal?

Bloating and digestion: apple cider vinegar has long been promoted to help with bloating. One problem is that the exact cause of bloating isn’t straightforward. Therefore addressing this common gut complaint needs a little nutritional detective work. Bloating can be due to low stomach acid or constipation or it could be due to something else. Many believe that the acetic acid in apple cider vinegar will help with the digestion of protein-rich foods. The stomach produces acid for this reason but as we age, we make less of it. Bloating is a legit consequence of low stomach acid but to date, there isn’t any robust research showing that apple cider vinegar will do the trick.

Having said that, anecdotally I’ve had clients benefit from taking some apple cider vinegar diluted in water with meals when it came to relieving some post meal ‘heaviness’. This was suggested after a proper assessment was done and other causes of digestive issues were ruled out and addressed. Don’t use vinegar as self treatment first. If you’re having troubling digestive and gut issues, seek professional help.

Heartburn. Could It Really Be Due To LOW Stomach Acid?

Reflux: for many, reflux is due to low stomach acid production, not from an excess. Most automatically think that any regurgitation and pain is from having too much stomach acid. But, even those on acid reducing medications will feel burning with reflux. This is because the esophagus doesn’t have a protective layer of mucous like the stomach does so don’t let burning fool you into thinking you have too much acid.

A lack of adequate stomach acid can result in altered digestion, food fermentation, and gas production. Supporting the stomach with additional acid from apple cider vinegar seems intuitive but again, there isn’t a ton of research.

Anti-bacterial: this one is true. That is if you’re looking for a non-toxic, ‘natural’ antibacterial cleaning agent. Acetic acid, the organic acid found in all vinegar DOES have antimicrobial properties. However, when it comes to your internal environment, apple cider vinegar is no match for the antibacterial, antifungal and antimicrobial properties of your own stomach and bile acids. Vinegar of any kind won’t make a dent in your fight against pathogens.

Gut inflammation: some of the claims for this claim is that apple cider vinegar will ease inflammation by supporting the digestion of problematic foods. As well, by helping to prevent the overgrowth of bad bacteria, apple cider vinegar will prevent and/or reduce gut inflammation.

If only it was that simple. This just isn’t true.

Functional Properties of Vinegar


Did I mention it’s highly acidic? Drinking a lot of apple cider vinegar can:

  • Damage your teeth
  • Irritate your throat
  • Upset your stomach
  • May also cause your potassium levels to drop too low
  • May aggravate your symptoms if you have an ulcer

FUN FACT: as with any vinegar, apple cider vinegar DOES NOT cause ulcers but may make symptoms worse if you do have an existing ulcer.

tuna salad – tuna, spinach, egg, tomatoes, mustard on a plate on wooden background. the view from the top

Should you include apple cider vinegar?

In short, apple cider vinegar probably won’t hurt you. Enjoy it in your diet because it’s calorie-free, adds lots of flavor to food, and anecdotal evidence suggests it might be helpful. But it’s not a miracle cure

Here are some other ways to add apple cider vinegar to your day:

  1. Make a hot ‘tea’. Add 1 to 2 tsp of apple cider vinegar to 1 cup of hot water. Add 1 tsp of lemon juice (optional). Sweeten with a drizzle of honey or maple syrup.
  2. Dilute some in water. add 1 to 2 tsp to 1 cup of water and take with meals.
  3. Use on a salad. it makes an excellent salad dressing. For a quick and easy dressing, blend 1 tablespoon of apple cider vinegar with 1 tablespoon of olive oil. Add a dash of ground pepper.
  4. Quick ‘pickles’. Growing up my mother would put onions and cucumber slices in white vinegar to ‘pickle’ them. Substitute apple cider vinegar for a twist.

Doug Cook RDN is a Toronto based integrative and functional nutritionist and dietitian with a focus on digestive, gut, and mental health. Follow him on Facebook, Instagram and Twitter.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *