Apple Cider Vinegar Side Effects: Risks, Dangers, and Safe Usage

Simple tips to avoid hazards and maintain balance in everyday wellness routines.

By Medha deb

Created on Sep 18, 2025

Simple tips to avoid hazards and maintain balance in everyday wellness routines.

Apple cider vinegar (ACV) has secured a place in countless kitchens and wellness routines as a home remedy for a wide array of ailments. From aiding weight loss and digestion to fighting germs, its purported benefits are versatile and well-publicized. However, large or improper consumption of ACV may lead to unwanted side effects—some mild, others potentially damaging. This article explores the science-backed side effects, risks, and best practices for using apple cider vinegar safely.

Overview of Apple Cider Vinegar
Potential Side Effects of Apple Cider Vinegar
Digestive Issues
Low Potassium and Bone Health
Tooth Enamel Erosion and Oral Health
Skin Burns and Irritation
Drug Interactions and Special Populations
How to Use Apple Cider Vinegar Safely
Frequently Asked Questions (FAQs)

Overview of Apple Cider Vinegar

Apple cider vinegar is produced from fermented apple juice. The fermentation process yields acetic acid, its main active compound, which is responsible for its strong scent, tangy taste, and purported health effects. ACV is used in salad dressings, marinades, food preservation, household cleaning, and various beauty applications. Despite its popularity, scientific evidence supporting many claimed benefits is limited, and side effects are not uncommon with misuse or overconsumption.

Potential Side Effects of Apple Cider Vinegar

While small, diluted amounts are generally safe for most adults, excessive or improper use of apple cider vinegar can cause:

Delayed stomach emptying and digestive discomfort
Nausea or indigestion
Low potassium (hypokalemia) and bone loss
Tooth enamel erosion and dental sensitivity
Burns and irritation (especially when applied to skin)
Medication interactions

1. Digestive Issues

Apple cider vinegar’s acetic acid slows the rate at which your stomach empties food into the intestines. This can cause unpleasant digestive symptoms, particularly in people with existing gastrointestinal conditions.

Delayed Gastric Emptying: For some, especially those with diabetes and gastroparesis (a disorder that slows stomach emptying), ACV can worsen symptoms like bloating, heartburn, and nausea. This can complicate blood sugar management, as it makes it hard to predict how quickly nutrients are absorbed.
Nausea and Indigestion: Studies indicate that ACV—especially when consumed as an unpleasant-tasting drink—can cause more pronounced feelings of nausea. Some people use ACV to reduce appetite, but this appetite suppression is often due to stomach upset rather than beneficial metabolic changes.

Summary: People with digestive disorders, acid reflux, or diabetes should be particularly cautious with apple cider vinegar, as it may aggravate symptoms and delay food absorption.

2. Low Potassium Levels and Bone Health Risks

Large or chronic intake of apple cider vinegar may cause low potassium levels (hypokalemia) and affect bone health.

Hypokalemia: Prolonged, high, daily doses of ACV have been linked to dangerously low potassium in the blood, which can cause muscle weakness, heart rhythm disturbances, and risk of paralysis.
Bone Loss: There are rare case reports where excessive vinegar intake over several years contributed to osteoporosis (weakening of the bones), possibly due to mineral loss as the body tries to neutralize excess acid from the vinegar. Such cases are extreme, but they illustrate the risks associated with chronic high usage.

Summary: Chronic or excessive use of apple cider vinegar may disrupt potassium balance, endanger heart function, and contribute to bone mineral depletion.

3. Tooth Enamel Erosion and Oral Health Problems

One of the most widely recognized side effects of regular ACV use is erosion of tooth enamel. This is due to its high acidity.

Tooth Decay: Consuming undiluted or highly acidic substances regularly wears away the protective enamel covering teeth, leading to increased sensitivity, a higher risk of cavities, and eventual tooth decay.
Dentinal Sensitivity: As enamel erodes, teeth become more sensitive to hot, cold, or sweet foods. People may not notice the damage until it becomes severe.
Prevention Tips: Diluting ACV, using a straw, or consuming it as part of a meal can reduce but not eliminate the risk. Avoid brushing teeth immediately after consuming acidic drinks, as this can worsen enamel erosion.

Oral Health Risks of Apple Cider Vinegar
Risk	Symptoms	Prevention
Enamel erosion	Sensitivity, pain, cavities	Dilute ACV, use a straw, rinse mouth
Tooth decay	Aching, visible holes	Limit frequency, consume with food

4. Skin Burns and Irritation

Undiluted apple cider vinegar can cause skin burns, irritation, or even chemical injuries when applied directly. Owing to its strong acidity (acetic acid concentration typically 4-7%), ACV is not safe for prolonged or concentrated topical use.

Skin Burns: Reports of burns, blisters, and skin darkening exist where undiluted ACV was left on the skin for too long, especially on the face, under bandages, or for wart removal.
Facial Damage: Due to facial skin being delicate, facial applications of ACV (mask, toner) are particularly risky and may cause black marks or permanent scarring if not diluted properly.
Scalp and Hair: Direct, concentrated ACV may lighten hair or dry out the scalp; it should always be diluted, if used cosmetically.

Note: If you experience stinging, redness, or burns following ACV exposure, rinse thoroughly with water and seek medical advice if significant irritation persists.

5. Drug Interactions and Special Populations

ACV interacts with certain medications and may be unsafe for people with specific conditions:

Diuretics and Laxatives: These can already lower potassium. ACV can exacerbate this effect, causing dangerous potassium deficiency.
Insulin and Diabetes Medications: ACV may affect blood sugar and insulin levels, and when combined with such medications, it could cause hypoglycemia (excessively low blood sugar). People with diabetes should consult a doctor before starting ACV.
Heart Medication: Some drugs for heart disease or high blood pressure may interact with the electrolyte (potassium) imbalance caused by ACV.
Pregnant or Breastfeeding Persons: There is insufficient safety data for regular or high-dose ACV use in these groups; consult a health professional before use.

How to Use Apple Cider Vinegar Safely

Despite the potential side effects, many adults can include small, diluted amounts of ACV in their diet without issue. To minimize risks:

Always dilute ACV (at least 1 part vinegar to 10 parts water) before drinking or applying topically.
Limit intake to 1–2 tablespoons (15–30 mL) per day, diluted in a large glass of water.
Drink through a straw and rinse your mouth with plain water afterward to protect tooth enamel.
Do not apply undiluted ACV to skin; dilute and patch-test first.
Monitor for side effects, especially if taking medications for diabetes, heart, or kidney conditions.
Consult your healthcare provider before starting ACV supplements or if you have chronic health problems.

Quick Safety Table

Best Practices	Why?
Dilute before drinking/applying	Prevents burns, esophageal irritation, enamel erosion
Limit dosage	Reduces risk of digestive, heart, and kidney problems
Discuss with doctor if on medication	Prevents drug interactions
Monitor side effects	Early recognition of unwanted problems

Frequently Asked Questions (FAQs)

Q: What is the best way to take apple cider vinegar to avoid side effects?

A: Always dilute ACV in water (at least 1:10 ratio), avoid drinking it on an empty stomach, and never use undiluted ACV on your skin or hair.

Q: Can apple cider vinegar damage your kidneys or liver?

A: There is no evidence of ACV causing direct liver or kidney damage in moderate doses, but excessive, chronic use may stress these organs, especially in people with pre-existing problems.

Q: Who should avoid apple cider vinegar?

A: People with chronic digestive problems, potassium disorders, diabetes (especially if on insulin), oral health issues, pregnant or breastfeeding individuals, and those on heart/kidney medications should consult their doctor before using ACV regularly.

Q: Can apple cider vinegar burn your skin?

A: Yes, undiluted or concentrated ACV can cause skin burns and discoloration, particularly if left on the skin for prolonged periods or if applied to sensitive areas.

Q: Is it safe to brush teeth after drinking apple cider vinegar?

A: Wait at least 30 minutes before brushing to allow your saliva to neutralize the acid and protect enamel from erosion.

Q: Does apple cider vinegar interact with medication?

A: Yes, especially with diuretics, laxatives, drugs for diabetes, and some heart medications. Always check with a healthcare professional before combining ACV with prescription drugs.

Q: Can children consume apple cider vinegar?

A: ACV is not recommended as a regular supplement for children due to risks associated with acidity, tooth enamel, and variable dosing safety.

Key Takeaways

Moderation is crucial when consuming apple cider vinegar.
Dilution helps minimize the risk of digestive, dental, and skin problems.
Consult your healthcare provider if you have chronic health conditions or are taking medications.
Always observe for side effects and stop use if unwanted symptoms develop.

Apple cider vinegar may offer some wellness benefits, but being aware of its potential drawbacks is vital for safe use.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

Read full bio of medha deb