7 Potential Side Effects of Apple Cider Vinegar
Nutrition & FitnessDiet & Nutrition

7 Potential Side Effects of Apple Cider Vinegar

7 Potential Side Effects of Apple Cider Vinegar
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Updated on October 16, 2025
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Apple cider vinegar is made by fermenting apples. The fermentation process turns the sugars of the apples into alcohol, which bacteria then convert to acetic acid.

Apple cider vinegar (ACV) has gained a reputation as a cure-all, with proponents claiming it can help with everything from weight loss to reducing the risk of cancer.

The main benefits of ACV come from substances you won't find listed on the nutrition label: acetic acid, antioxidants, and probiotics (good bacteria).

Is It Good to Take Apple Cider Vinegar?

“Apple cider vinegar is one of those common pantry staples that actually has a little bit of science behind the claims that it’s good for you,” says Melissa Groves Azzaro, RDN. “It’s affordable and accessible, making it easy to try for most people.”

However, there are some limitations to that belief. “The effects are modest to trivial, and have very little science supporting them,” says David L. Katz, MD, MPH, founding director of the Yale-Griffin Prevention Research Center in New Haven, Connecticut, and founder-president of True Health Initiative. “Mostly it’s about the perpetual hunt for a quick fix, rather than embracing the elements of a healthy lifestyle.

Apple cider vinegar also comes with a few health concerns. “Apple cider vinegar is not safe for everyone, especially when consumed at full strength,” Azzaro says.

If you do decide to take it, she suggests sticking to a serving size of 1 teaspoon to 1 tablespoon at most — and making sure you dilute it first. Azzaro recommends mixing the vinegar in at least 8 ounces of water and only consuming it with a meal.

“If your stomach burns or your teeth hurt, apple cider vinegar is not for you,” she says.

Azzaro also says that if you have sensitive skin, you should be careful about applying it topically, which some people do for its potential skin benefits.

People with diabetes who use apple cider vinegar to help with blood sugar control should do so with caution and refrain from relying on it as their main treatment.

If you’re otherwise healthy and haven’t experienced any negative reactions to it in the past, you may consider trying apple cider vinegar. However, be sure to be on the lookout for these negative side effects.

1. Increased Risk of Hypoglycemia When Used With Insulin

Apple cider vinegar has become a popular trend for managing blood sugar in people with type 2 diabetes. This is in part thanks to research that indicates consuming ACV daily can help lower fasting blood glucose levels. The effect may be due to a number of mechanisms, including delayed gastric emptying (when food moves from your stomach into your 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 potential blood sugar-lowering effects, taking apple cider vinegar with diabetes medications might 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 Issues, Especially for 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 your stomach.

While this is great if you’re trying to extend feelings of fullness and consume fewer calories, it may not be so great for people with gastroparesis.

Gastroparesis is a disorder that affects the nerves and muscles of your stomach. This leads to food sitting in your stomach for too long, causing digestive issues.

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 nerves and blood vessels, which can affect 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 that you’re doing it safely.

3. Esophageal Burns

Because apple cider vinegar is so acidic, it can lead to throat irritation.

 Drinking ACV without first diluting it in water can also burn your esophagus.

While it’s unclear how common these episodes are, many experts, including Dr. Katz and Michelle Jaelin, a registered dietitian in Ontario, Canada, still recommend diluting apple cider vinegar in water before drinking. “It is an acid and can damage the lining of the esophagus if taken straight like a shot,” Jaelin says.

4. Interactions With Other Medication

Katz says that taking apple cider vinegar may interfere with certain medicines. Specifically, it might affect those taking diuretics, laxatives, or insulin. Laxatives and diuretics, like water pills, can cause fluid loss, leading to lower potassium levels. Taking these together with apple cider vinegar may cause potassium levels to become too low.

It’s a good idea to speak with your doctor or pharmacist before taking apple cider vinegar, to make sure that you’re in the clear.

5. Decreased Potassium Levels

Regularly consuming large amounts of apple cider vinegar can lower levels of potassium in your blood.

Low potassium levels can lead to:

  • Weakness
  • Fatigue
  • Constipation
  • Muscle cramps
  • Irregular heart rhythms (arhythmias)
ACV’s potassium-lowering effects are especially worrisome for people who take medications that also lower potassium, such as diuretics to treat high blood pressure. These people should steer clear of taking ACV.

6. Tooth Erosion

“Vinegar is highly acidic,” Katz says. “It can severely damage tooth enamel.” Because of this, many experts are wary of apple cider vinegar, and proponents suggest diluting it with water instead of drinking it straight.

According to a review published in 2021, consuming more acidic foods and beverages increases the likelihood of dental erosion or enamel demineralization.

 This weakens your teeth, making them more susceptible to stains, sensitivity, and cavities.

Eroded tooth enamel can also make your teeth 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 out your mouth with plain water immediately after.”

7. Chemical Burns on the Skin

Some people apply apple cider vinegar directly to their skin as a toner. Many consider it a home remedy for clearing up skin problems like acne and signs of aging.

But before you think about trying it as a secret weapon for clear skin, be aware that undiluted ACV comes with a risk of irritation.

“It’s a rare but ultimately possible side effect anytime you put undiluted apple cider vinegar on the skin,” says Nazanin Saedi, MD, a dermatologist and clinical associate professor at Thomas Jefferson University in Philadelphia.

Because of this, she doesn’t recommend applying it or any other highly acidic products to your face. “They’re just too harsh,” she says.

Instead, avoid the DIY route altogether and choose a toner aimed at the specific problem you’re facing, such as salicylic acid to treat breakouts.

The Takeaway

  • Apple cider vinegar has potential health benefits, but it also carries a risk of side effects.
  • Potential side effects of apple cider vinegar include low blood sugar, esophageal burns, skin irritation, and tooth erosion.
  • Consulting your physician before trying apple cider vinegar, and diluting it with water, can help decrease the risk of side effects.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. What Apple Cider Vinegar Can (and Can’t) Do for You. Cleveland Clinic. May 20, 2025.
  2. Apple Cider Vinegar. MedlinePlus. December 19, 2024.
  3. Arjmandfard D et al. Effects of Apple Cider Vinegar on Glycemic Control and Insulin Sensitivity in Patients With Type 2 Diabetes: A GRADE-Assessed Systematic Review and Dose–Response Meta-Analysis of Controlled Clinical Trials. Frontiers in Nutrition. January 30, 2025.
  4. Gastroparesis. Cleveland Clinic. February 12, 2025.
  5. Drinking Apple Cider Vinegar for Weight Loss Seems Far-Fetched. Does It Work? Mayo Clinic. March 4, 2025.
  6. Low Potassium (Hypokalemia). Mayo Clinic. March 21, 2025.
  7. Apple Cider Vinegar for Weight Loss: Does It Really Work? Harvard Health Publishing. June 15, 2023.
  8. Sato T et al. The Onset of Dental Erosion Caused by Food and Drinks and the Preventive Effect of Alkaline Ionized Water. Nutrients. September 28, 2021.
  9. Tooth Erosion. Cleveland Clinic. September 14, 2023.
  10. Luu LA et al. Apple Cider Vinegar Soaks Do Not Alter the Skin Bacterial Microbiome in Atopic Dermatitis. PLoS One. June 2, 2021.
  11. Salicylic Acid Topical. MedlinePlus. October 15, 2023.
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Kara Andrew, RDN, LDN

Medical Reviewer
Member of American College of Lifestyle Medicine

Kara Andrew, RDN, LDN, is the director of health promotion for Memorial Hospital in Carthage, Illinois. She is also licensed as an exercise physiologist and certified in lifestyle medicine by the American College of Lifestyle Medicine. Her experience includes corporate wellness, teaching for the American College of Sports Medicine, sports nutrition, weight management, integrative medicine, oncology support, and dialysis.

She earned her master's in exercise and nutrition science at Lipscomb University.

Andrew has served as a president and board member of the Nashville Academy of Nutrition and Dietetics. She was recently elected a co-chair of the fitness and medicine group in the American College of Lifestyle Medicine.

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Moira Lawler is a journalist who has spent more than a decade covering a range of health and lifestyle topics, including women's health, nutrition, fitness, mental health, and travel. She received a bachelor's degree from Northwestern University’s Medill School of Journalism and lives in the Chicago suburbs with her husband, two young children, and a giant brown labradoodle.
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