Can apple cider vinegar cause organ damage? Exploring the risks

December 29, 2025 •

4 min read

With a highly acidic pH level between 2 and 3, apple cider vinegar (ACV) is a potent substance, leading many to question its safety for internal organs. While moderate and diluted consumption is generally considered safe for most healthy individuals, excessive intake is where the risk of harm, and the question of, 'can apple cider vinegar cause organ damage?' becomes more serious.

Quick Summary

This article examines how excessive and undiluted consumption of apple cider vinegar can harm internal organs, specifically stressing the kidneys and potentially affecting the liver. It details the risks associated with high acidity and offers important safety guidelines for consumption.

Key Points

Acidity is the Main Culprit: Apple cider vinegar's high level of acetic acid (pH 2-3) is what can cause damage to the body's tissues and organs if consumed excessively or undiluted.
Kidney Strain is a Concern: The kidneys, which regulate the body's acid balance, can be stressed by high ACV intake, and those with existing kidney disease should avoid it.
Liver Damage is a Rare but Documented Risk: While infrequent, there is one case report of hepatotoxicity (liver damage) linked to long-term, high-dose apple cider vinegar consumption.
Dental and Esophageal Erosion is Common: The acidic nature of ACV can irreversibly erode tooth enamel and cause painful burns or irritation to the esophagus.
Low Potassium is a Dangerous Side Effect: Overuse of ACV can deplete the body's potassium levels, leading to serious health issues like muscle weakness and irregular heartbeats.
Dilution and Moderation are Crucial: The safest way to consume ACV is to dilute no more than 1-2 tablespoons per day in a large glass of water.

Understanding the Acidity of Apple Cider Vinegar

Apple cider vinegar is primarily composed of acetic acid, a highly acidic compound responsible for its pungent odor and flavor. While this component is also linked to its purported health benefits, its corrosiveness is a significant factor in its potential to cause harm. The pH scale is a measure of acidity and alkalinity, where a lower number indicates higher acidity. ACV's pH of 2 to 3 means it is very acidic, similar to lemon juice, and prolonged, undiluted exposure is damaging to sensitive tissues throughout the body.

How Excessive Acidity Affects Internal Organs

Regularly consuming high amounts of any acidic substance puts a strain on the body's systems, particularly the kidneys. The kidneys are responsible for regulating the body's pH balance, and when they are constantly forced to process a high acid load, their function can be compromised. This is especially concerning for people with pre-existing kidney disease, who should avoid overusing ACV entirely.

The Impact on the Liver: A Rare but Documented Risk

While apple cider vinegar is not a primary cause of liver disease, excessive consumption over a long period has been linked to liver damage in rare instances. A case report in 2025 documented a 60-year-old man who developed hepatotoxicity (liver damage) after consuming significant amounts of ACV for four years. This highlights that while infrequent, idiosyncratic reactions can occur, making it important to consider all dietary factors, including home remedies, when investigating liver issues. Most studies show that moderate intake is unlikely to harm a healthy liver, but caution is warranted.

Other Significant Side Effects of Excessive Apple Cider Vinegar

Beyond the potential for organ damage, there are several other notable risks associated with overconsumption of ACV:

Dental Erosion: The high acidity directly erodes tooth enamel, the protective outer layer of teeth. Once enamel is lost, it cannot be regenerated, leading to increased tooth sensitivity, discoloration, and decay. Using a straw and rinsing with water can mitigate this risk.
Esophageal Burns: Drinking undiluted ACV can cause irritation and even burns to the esophagus and throat due to its caustic nature. In one case, an ACV tablet caused throat burns after it became lodged in a woman's esophagus.
Gastrointestinal Distress: High intake can irritate the stomach lining, leading to nausea, indigestion, bloating, and heartburn. It can also delay gastric emptying, which is particularly problematic for individuals with diabetes.
Low Potassium and Bone Density Loss: Long-term, excessive ACV consumption can lower the body's potassium levels (hypokalemia). This can cause muscle cramps, weakness, abnormal heart rhythms, and, over time, affect bone density.
Drug Interactions: ACV can interact dangerously with certain medications, including diuretics, insulin, and some heart medicines, which can lead to dangerously low blood sugar or potassium levels.

Safe vs. Excessive Apple Cider Vinegar Consumption

To better understand the difference between safe and risky ACV use, consider the following comparison.


Aspect	Safe Consumption	Excessive Consumption
Dosage	1-2 tablespoons per day, maximum.	Large amounts, frequently or daily.
Dilution	Always diluted in a large glass of water.	Drunk straight or insufficiently diluted.
Frequency	Once or twice a day, or as part of a meal.	Multiple times a day, on an empty stomach.
Method	Sipped through a straw and mouth rinsed with water afterward.	Drunk directly, allowing prolonged contact with teeth.
Medical Condition	Checked with a doctor before use, especially if on medication or with underlying health issues.	Ignored warnings from healthcare providers.
Purpose	Used for flavor in cooking or as a diluted beverage.	Used as a purported 'cure-all' to excess.

Expert Consensus on Long-Term Risks

While research on the long-term effects of daily apple cider vinegar use is limited, most experts agree that moderation and proper dilution are crucial for safety. The National Center for Complementary and Integrative Health (NCCIH) advises against replacing proven medical treatments with unproven health products and emphasizes that healthy individuals, even with moderate ACV use, should not expect major health benefits without other lifestyle changes. Larger, long-term studies are needed to confirm the sustained benefits and to fully understand all potential risks. For instance, while some studies show benefits for blood sugar and weight loss, these are often short-term and with small sample sizes.

Conclusion

In summary, while apple cider vinegar offers potential benefits, the claim that it can cause organ damage is not entirely without merit. Excessive or undiluted consumption is the primary risk factor, particularly for vulnerable organs like the kidneys and, in rare cases, the liver. For most healthy individuals, moderate, diluted intake is safe. However, the corrosive nature of ACV poses risks of dental erosion and damage to the esophagus. Anyone with pre-existing health conditions or on medication should consult a doctor before starting a regimen of ACV. Responsible usage, including dilution and limiting intake, is key to avoiding these potential dangers and ensuring that this popular health tonic remains a safe part of your diet. For additional medical information on the risks of supplements, consult the NIH's authoritative resources on drug interactions and toxicities.

Frequently Asked Questions

Yes, excessive or long-term consumption of apple cider vinegar can stress the kidneys, especially for individuals with pre-existing kidney disease, as the kidneys work to process the high acid load.

There is a rare but documented risk of liver damage from long-term, high-dose ACV consumption, as shown in one case report. For most healthy individuals, moderate intake is unlikely to cause liver issues.

To protect your tooth enamel from erosion, always dilute ACV with water, use a straw to minimize contact, and rinse your mouth with plain water afterward.

Yes, drinking undiluted apple cider vinegar is dangerous. Its high acidity can cause painful burns and irritation to the esophagus and throat.

Yes, ACV can interact with certain medications, including insulin, diuretics, and some heart medicines. These interactions can lead to dangerously low blood sugar or potassium levels, so consult your doctor first.

Signs of excessive consumption include digestive issues like nausea and heartburn, tooth sensitivity, muscle cramps or weakness from low potassium, and throat irritation.

Experts generally recommend limiting daily intake to 1 to 2 tablespoons, and always diluting it in a large glass of water. Start with a smaller dose to see how your body reacts.