Apple cider vinegar is extracted from fermented apples (1). It is a popular ingredient in many food dressings and preservatives. Moderate intake of this healthy tonic has many health benefits. However, excess consumption can cause some adverse effects, such as gastrointestinal issues, digestive problems, lower potassium levels (hypokalemia), and tooth decay.
This article discusses the potential side effects of apple cider vinegar. We also will look at the safer ways of consumption and the consequences of overconsumption. Read on to know more.
Side Effects Of Apple Cider Vinegar
1. May Cause Gastrointestinal Issues
Excess consumption of apple cider vinegar may cause gastrointestinal issues. It may slow down the process of absorption of food in the bloodstream. A study conducted by Lund University found that apple cider vinegar delayed the gastric emptying rate (2). Though this could be beneficial in some cases, it can cause digestive distress in some individuals.
Increased intake of apple cider vinegar may also worsen symptoms of gastroparesis, a common condition in people with type 1 diabetes (3). However, more studies in this line are needed to reach further conclusions.
2. May Cause Digestive Problems
Apple cider vinegar may help reduce appetite. A study shows that apple cider vinegar acts as an appetite suppressant and promotes feelings of fullness, leading to a natural reduction in food intake. Though this could be helpful for people trying to lose weight, the vinegar can also cause subsequent nausea (4).
However, more studies are needed to further understand this side effect of apple cider vinegar.
3. May Cause Hypokalemia
Anecdotal evidence suggests that excessive use of apple cider vinegar may lower the potassium levels in the body. It may also reduce bone mineral density, which, in turn, makes bones brittle. Hence, individuals with osteoporosis may have to reduce or avoid the intake of apple cider vinegar.
A case of hypokalemia was observed in a 28-year-old woman who had reportedly taken 250 ml of ACV regularly for 6 years (5). More research is needed in this regard.
4. May Cause Tooth Decay
The high acidity of undiluted apple cider vinegar can damage your tooth enamel if consumed in excess. Besides giving a yellowish tinge to your teeth, the vinegar may also increase your dental sensitivity.
A study states that apple cider vinegar may have an erosive potential that may cause tooth decay (6). Another study states the case of a 15-year-old girl who had experienced tooth erosion following the daily intake of apple cider vinegar (7).
5. May Cause Throat Burns
Increased consumption of apple cider vinegar may cause throat burns. Many studies have concluded that the oral overuse of apple cider vinegar can eventually lead to throat irritation. The acetic acid in the vinegar could be the primary cause (8).
A study conducted by the University of Arkansas found that apple cider vinegar tablets may also lead to esophageal injury (8). It is a potent caustic substance, and accidental ingestion of vinegar may lead to esophageal lesions in children (9).
6. May Cause Skin Burns
The strong acidic nature of apple cider vinegar may cause skin burns. Applying apple cider vinegar directly to the skin can cause burns and irritation, especially if the vinegar is undiluted.
In a study, a 14-year-old girl developed burns on her nose after applying several drops of apple cider vinegar to remove two moles (10). There are several other anecdotal studies that suggest that apple cider vinegar causes skin burns.
7. May Interact with Certain Drugs
There is no sufficient information available in this regard. Since it is acidic, apple cider vinegar may easily react with some drugs including laxatives and diuretics.
Apple cider vinegar may have a direct effect on insulin levels and blood sugar. Taking it along with blood pressure and diabetes medications may cause harm. However, more studies in this line are needed to reach further conclusions. If you are on any medication, consult your doctor before taking apple cider vinegar.
8. May Cause Low Blood Sugar Levels
The excessive use of apple cider vinegar may lower blood-sugar levels. The vinegar has an anti-glycemic effect (5), (11). However, taking it along with diabetes medications may cause your blood sugar levels to drop way too low. This, if not treated, may lead to unconsciousness and even coma. More research is needed to further understand this phenomenon.
Apple cider vinegar is also not advised for pregnant/lactating women and those undergoing chemotherapy treatment. It may cause complications. However, there is insufficient information in this regard.
These are the potential adverse effects of apple cider vinegar. Most of these need further research to be thoroughly validated. However, this does not mean one must totally avoid ACV. There is a way to consume it by minimizing the risk of side effects.
How To Consume Apple Cider Vinegar Safely
The intake of excess and undiluted apple cider vinegar daily may cause possible adverse effects.
To minimize these effects, you can try:
- Diluting the apple cider vinegar with water.
- Reducing the quantity of vinegar intake.
- Limiting contact with the teeth by drinking vinegar through a straw.
- Reducing the amount of time vinegar touches the skin.
- Rinsing your mouth with water after consumption to prevent further damage to the teeth.
You can also ensure you consume ACV in the recommended doses to potentially avoid side effects.
The recommended dose of apple cider vinegar varies depending on your individual needs. However, a daily intake of 15 ml of apple cider vinegar is enough to enjoy its potential health benefits (12).
Before you apply apple cider vinegar to your skin, dilute it with water. Also, do a patch test.
Apple cider vinegar offers many health benefits when consumed in moderate amounts. However, excess intake leads to several potential adverse effects. Hence, limit your dosage to less than 15 ml per day. Dilute the vinegar before use, whether orally or topically. Since ACV may interact with medications, consult your doctor before taking it if you are on any medication.
Expert’s Answers For Readers’ Questions
What should we keep in mind before buying apple cider vinegar?
To avoid any drastic damage to your skin and health, consider going for organic apple cider vinegar that contains living supplements and microorganisms.
Also, read through the label of the bottle before you buy it. Any brand that has the right constituents is good. Go for Heinz and Bragg – these two brands are popular for the right reasons.
How do you identify organic apple cider vinegar?
The organic and natural apple cider vinegar is unpasteurized and crude. It is considered the best due to its presence of actual microscopic organisms that are known to treat a spectrum of ailments.
But if you are unable to identify the natural variant, go for the unfiltered and unheated version that contains strand-type sediments at the bottom of the jar. Make sure you shake the bottle before use. Non-organic ACV does not have any sediments and appears unnaturally clear, and you may want to avoid it.
Can apple cider vinegar be consumed with beverages?
Caffeine may affect the absorption of apple cider vinegar. Hence, if you want to mix it with your beverage, use homegrown decaf tea. Mixing it with caffeine or other carbonated beverages may make the mixture too acidic. Taking it with honeyed water is best.
What time of the day is best for consuming apple cider vinegar?
You can consume apple cider vinegar at any time of the day, except for the time after you wake up. Taking it on an empty stomach may cause digestive distress. Consuming apple cider vinegar an hour before your meals can help in the proper functioning of your digestive system.
How often should apple cider vinegar be consumed on a daily basis?
This depends on what your doctor suggests. However, consuming it twice a day is safe.
Can ACV be taken in the form of pills?
Yes, you can consume apple cider vinegar in any form you like, but make it a point not to overdo it.
Who should avoid using apple cider vinegar?
Apple cider vinegar is known to have a huge impact on a woman’s body. Pregnant women and lactating mothers are generally advised to avoid consuming apple cider vinegar. People who are on medication or going through chemotherapy should also avoid consuming apple cider vinegar.
Can I brush my teeth with apple cider vinegar?
No. The acetic acid in the vinegar may weaken your enamel. Also, make sure you cleanse your mouth well after you consume apple cider vinegar (diluted).
Can apple cider vinegar affect the liver and kidneys?
There is no research stating that ACV can harm the liver or kidneys. In fact, it could benefit them (13).
- Cousin, Fabien J et al. “Microorganisms in Fermented Apple Beverages: Current Knowledge and Future Directions.” Microorganisms vol. 5,3 39. 25 Jul. 2017.
- Liljeberg H, Björck I. Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. Eur J Clin Nutr. 1998;52(5):368–371.
- Hlebowicz, Joanna et al. “Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study.” BMC gastroenterology vol. 7 46. 20 Dec. 2007.
- Darzi J, Frost GS, Montaser R, Yap J, Robertson MD. Influence of the tolerability of vinegar as an oral source of short-chain fatty acids on appetite control and food intake. Int J Obes (Lond). 2014;38(5):675–681.
- Johnston, Carol S, and Cindy A Gaas. “Vinegar: medicinal uses and antiglycemic effect.” MedGenMed : Medscape general medicine vol. 8,2 61. 30 May. 2006.
- Willershausen I, Weyer V, Schulte D, Lampe F, Buhre S, Willershausen B. In vitro study on dental erosion caused by different vinegar varieties using an electron microprobe. Clin Lab. 2014;60(5):783–790.
- Gambon DL, Brand HS, Veerman EC. Ongezond afslanken. Erosie door appelazijn [Unhealthy weight loss. Erosion by apple cider vinegar]. Ned Tijdschr Tandheelkd. 2012;119(12):589–591.
- Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. J Am Diet Assoc. 2005;105(7):1141–1144.
- Nuutinen M, Uhari M, Karvali T, Kouvalainen K. Consequences of caustic ingestions in children. Acta Paediatr. 1994;83(11):1200–1205.
- Feldstein S, Afshar M, Krakowski AC. Chemical Burn from Vinegar Following an Internet-based Protocol for Self-removal of Nevi. J Clin Aesthet Dermatol. 2015;8(6):50.
- Siddiqui, Fahad Javaid et al. “Diabetes Control: Is Vinegar a Promising Candidate to Help Achieve Targets?.” Journal of evidence-based integrative medicine vol. 23 (2018): 2156587217753004.
- Samad, Anuar, Azrina Azlan, and Amin Ismail. “Therapeutic effects of vinegar: a review.” Current Opinion in Food Science 8 (2016): 56-61.
- Nazıroğlu M, Güler M, Özgül C, Saydam G, Küçükayaz M, Sözbir E. Apple cider vinegar modulates serum lipid profile, erythrocyte, kidney, and liver membrane oxidative stress in ovariectomized mice fed high cholesterol. J Membr Biol. 2014;247(8):667–673.
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