Nothing exists in a vacuum. Our bodies are complex organisms that are constantly moving, with chemicals acting and interacting.
Sometimes substances work synergistically, bringing out the best in each other. Other times, they work antagonistically, making something that’s generally beneficial harmful instead.
Apple cider vinegar (ACV) can be used to promote optimal health, from skin and hair to proper digestion and weight loss. The proven benefits of apple cider vinegar include fighting deadly inflammation, healing bruises, and even killing cancer cells. For some, the whole body effect of apple cider vinegar is better than any medication, making it a popular home remedy.
When mixed with some pharmaceuticals or supplements, however, there are a number of potential side effects and drug interactions to consider.
Apple Cider Vinegar Side Effects: Contraindications for ACV
If you are taking any medication at all, it’s a good idea to consult with your healthcare provider or nutritionist to ensure no adverse reactions with any dietary supplement, including ACV.
Note: Vinegar used in cooking is fine because it’s diluted in the jumble of your stomach contents. When used alone in larger amounts as a supplement, however, the backdrop changes.
The following are medications and conditions that are known to interact with apple cider vinegar. While some side effects are mild, some interactions are quite serious, and will cancel out any health benefits.
1. Diabetes Medication
ACV can effectively regulate blood glucose, reducing sugar levels and stimulating insulin production. (1) If you’re taking an insulin injection or insulin-stimulating medication for diabetes, however, blood sugar can go down too far too fast.
In addition, potassium levels may significantly decrease with ACV, which has further implications for heart and muscle function and proper digestion.
Further, ACV slows the rate at which food is released from the stomach into the lower digestive tract and subsequently into the bloodstream. This is the mechanism for how ACV is effective in moderating blood glucose. (2)
Combined with diabetes medication, this may result in hypoglycemia, or low blood sugar.
Gastroparesis is a common consequence of type 1 diabetes in which the nerves in the stomach are dulled and digestion slows. Common symptoms of gastroparesis may be mild or nonexistent, but generally include nausea, vomiting, and feeling full after taking only a few bites of food. Taking ACV if you have gastroparesis slows down digestion too much, making it extremely difficult to regulate blood sugar levels. (3)
That being said, if you are have pre-diabetes (insulin resistance), taking apple cider vinegar can help lower blood sugar levels in the body without relying on medication. Talk to your doctor to rule out drug interactions with other medications you may be on.
“Water pills” are prescribed to reduce the amount of sodium and water in the body. They are used for glaucoma, hypertension, edema (swelling), and other conditions to relieve water retention and pressure, or as part of a weight management program. Diuretics stimulate the kidneys to release more sodium into urine, taking water from cells with it. In this way, the medication reduces blood pressure. (4)
Sodium and potassium in the body work in an inverse relationship: the more sodium present, the less potassium there is. If you are taking a diuretic to reduce sodium, you may already have a potassium deficiency, as potassium can get flushed out as well. (5) ACV can further decrease potassium levels.
Common diuretics include:
- Chlorothiazide (Diuril)
- Hydrochlorothiazide (Microzide)
- Bumetanide (Bumex)
- Ethacrynic acid (Edecrin)
- Furosemide (Lasix)
- Torsemide (Demadex)
- Eplerenone (Inspra)
- Spironolactone (Aldactone)
- Triamterene (Dyrenium)
3. Heart Medication
Drugs that regulate your heartbeat slow it down and force stronger heart contractions to maximize blood flow. Low potassium in the blood (whose function is to regulate heartbeat) is known to cause adverse effects of heart drugs like digoxin (Lanoxin).(6)
While ACV contains potassium and other minerals, together with this class of drug it can negatively affect the body’s absorption of potassium.
Digoxin side effects include:
- nausea or vomiting
- abdominal pain
- blurred vision
- skin rash
- slow or irregular heartbeat
- weakness and fatigue
- loss of appetite
As an aside, if you are taking digoxin for atrial fibrillation, you may want to discuss your treatment with your physician: a 2014 study published in the Journal of the American College of Cardiology found a significantly increased mortality risk with long-term use. (7)
ACV is probiotic and promotes healthy and efficient digestion of other foods and beverages.
Its hydrochloric acid is similar to stomach acids that break down food and its fiber helps to move things along the digestive tract.
If you’re taking a laxative in combination with ACV, you may end up with the opposite of constipation. That isn’t particularly pleasant either.
5. Pregnancy and Breastfeeding
Some authorities recommend avoiding ACV, others deem it safe while pregnant. Check with your OB/GYN or midwife before taking ACV medicinally.
One of the ways in which ACV helps with weight loss is by promoting a feeling of satiety (fullness) so you eat less.
For some people, it can also make them feel nauseous, which discourages eating anything and is not a healthy way to lose weight. (8) If you get a feeling of nausea from drinking ACV, discontinue use or consider taking apple cider vinegar tablets instead.
7. Erosion of Tooth Enamel
To consume apple cider vinegar safely, always dilute ACV in water or apple juice (1 cup of water or more per tablespoon of ACV). If you take ACV consistently over a long period of time, rinse your mouth immediately and thoroughly afterward with plain water. Also, don’t brush your teeth for at least 30 minutes, as this can spread the acid around!
8. Throat Burn
ACV is a mild acid. In some people, the acid content can cause irritation, resulting in sore throats.
A Finnish study of children who had been hospitalized for consuming caustic household products found that acetic acid (such as found in ACV and other vinegars) was the most common culprit of throat burns in children. (10)
Keep vinegar out of the reach of children. If you experience discomfort when taking ACV, consider heavily diluting the vinegar, taking apple cider vinegar tablets, or stopping altogether.
9. Skin Burns
The acid in ACV is ordinarily safe to apply to (unbroken) skin, especially if diluted. With repeated direct application, however, acid can burn skin. (11) Be sure to dilute or consider stopping application if you feel a worsening burning sensation.
Moreover, in people suffering from an autoimmune condition, the chemistry of the entire body is thrown out of whack. Using ACV to treat lesions or other skin problems can cause actual burning of skin due to immune system dysfunction. (12)
Finally, remember that it is possible to get too much of a good thing. If you are taking medication of any kind (including supplements and healing herbs), talk to your doctor first before adding or continuing with apple cider vinegar (or any other supplement). Figure out the best way to consume apple cider vinegar safely in order to get the most health benefits.