Is there a downside to drinking apple cider vinegar?

According to a case study published in Clinical Endoscopy, a teenager developed throat ulcers from drinking undiluted apple cider vinegar. This alarming account underscores the fact that while often hailed for its health benefits, there are significant downsides to drinking apple cider vinegar, especially when consumed incorrectly or in excessive amounts.

Quick Summary

The high acidity of apple cider vinegar can cause significant health problems, including tooth enamel erosion, digestive distress, and potential medication interactions. Risks are highest with undiluted or excessive consumption. Proper dilution is essential for safety.

Key Points

• Dental Damage: High acidity from undiluted or frequent apple cider vinegar consumption can erode tooth enamel, leading to sensitivity and decay.

• Digestive Distress: ACV can cause or worsen nausea, heartburn, and bloating, particularly for those with existing digestive issues or when consumed in large quantities.

• Drug Interactions: Apple cider vinegar can dangerously interact with medications like insulin, diuretics, and digoxin, affecting blood sugar and potassium levels.

• Low Potassium Risk: Excessive, long-term ACV intake has been linked to low potassium levels and weakened bones in some case studies.

• Esophageal Burns: Drinking undiluted apple cider vinegar can cause chemical burns and irritation to the throat and esophagus.

• Moderation is Key: To mitigate risks, always dilute apple cider vinegar, limit daily intake, and use a straw to protect teeth.

• Consult a Doctor: Individuals with certain health conditions or those on medication should consult a healthcare professional before incorporating ACV into their routine.

The Potential Risks of ACV Consumption

While proponents praise its potential benefits for blood sugar and weight management, it is crucial to recognize that the high acidity of apple cider vinegar (ACV) poses several health risks, particularly with improper use. The active component, acetic acid, is a potent substance that can damage delicate tissues if not handled correctly.

Damage to Tooth Enamel

One of the most well-documented side effects of regular ACV consumption is damage to tooth enamel. Enamel is the hard, protective outer layer of your teeth. The acetic acid in vinegar can weaken and erode this layer over time, leading to increased tooth sensitivity, discoloration, and a higher risk of cavities. Once enamel is gone, it cannot be replaced by the body. This risk is especially high for those who drink ACV undiluted or hold the liquid in their mouths.

Gastrointestinal and Digestive Problems

Excessive intake of ACV can cause significant gastrointestinal discomfort. Common issues include:

• Nausea and stomach upset
• Heartburn and worsened symptoms of acid reflux
• Delayed gastric emptying, which can cause bloating and nausea, and is a major concern for people with type 1 diabetes who also have gastroparesis

These digestive irritations are often caused by the high acidity affecting the esophagus and stomach lining.

Decreased Potassium and Bone Density Concerns

Though rare, long-term, high-dose consumption of ACV has been linked to low potassium levels, a condition known as hypokalemia. A case study of a 28-year-old woman who drank a cup of ACV daily for six years revealed low potassium and bone density issues. The treating physicians believed the large daily acid load leached minerals from her bones to maintain the blood's pH balance. Low potassium can cause fatigue, muscle weakness, and irregular heart rhythms.

Dangerous Drug Interactions

Apple cider vinegar can interfere with certain medications, potentially leading to dangerous health complications. It is crucial to consult a healthcare provider before using ACV if you are on medication. Interactions may occur with:

• Diuretics (Water Pills): Taking ACV with diuretics can lower potassium levels to dangerously low amounts.
• Insulin and Diabetes Medications: ACV's effect on lowering blood sugar can cause hypoglycemia (dangerously low blood sugar) when combined with insulin or other glucose-lowering drugs.
• Digoxin (Lanoxin): Low potassium levels, which can be caused by excessive ACV, can increase the side effects of this heart medication.

Potential for Esophageal and Skin Burns

Consuming undiluted ACV can cause chemical burns to the sensitive tissues of the throat and esophagus. This was tragically demonstrated in the case of the teenager mentioned earlier who developed throat ulcers. Additionally, applying undiluted ACV topically to the skin can cause severe irritation and chemical burns, a risk highlighted in numerous reports involving home remedies for skin conditions.

Comparison of Risks with Diluted vs. Undiluted ACV

Feature	Undiluted ACV (Shot)	Diluted ACV (1 tbsp in 8oz water)
Effect on Tooth Enamel	High risk of severe erosion and decay.	Significantly lower risk, especially when using a straw.
Throat & Esophagus	High risk of irritation and chemical burns.	Much lower risk; irritation is unlikely.
Digestive Upset	Increased chance of nausea, heartburn, and discomfort.	Reduced chance, though still possible for sensitive individuals.
Gastric Emptying	Can significantly delay stomach emptying.	Less pronounced effect on gastric emptying.
Overall Safety	Potentially unsafe for regular, long-term use.	Considered generally safe for most people in moderation.

Conclusion: Practice Caution and Dilution

While apple cider vinegar offers a range of potential health benefits, the evidence overwhelmingly points to the importance of caution. The primary downside to drinking apple cider vinegar stems from its high acidity, which can negatively impact dental health, digestive function, and mineral levels. Improper use can lead to serious health complications, especially for those with pre-existing conditions like diabetes or acid reflux, or those taking specific medications. The safest approach is always dilution and moderation. By incorporating a small, diluted dose into your diet, perhaps as a salad dressing, you can minimize risks while potentially enjoying some of the purported benefits. Before beginning any new health regimen, particularly with supplements, it is always wise to consult with a healthcare professional.

Safe Consumption Guidelines

• Dilute, dilute, dilute: Always mix 1–2 tablespoons of ACV in a large glass of water (at least 8 ounces) before consuming.
• Use a straw: Drink the diluted mixture through a straw to minimize contact with your teeth and protect your enamel.
• Rinse your mouth: After drinking, rinse your mouth with plain water to further reduce acid residue on your teeth.
• Limit intake: Restrict your daily consumption to no more than 1–2 tablespoons, and listen to your body.
• Wait to brush: Wait at least 30 minutes after consuming ACV before brushing your teeth, as brushing weakened enamel can cause further damage.

Who Should Be Cautious?

Certain individuals should be particularly careful or avoid ACV altogether:

• Diabetics with gastroparesis: The delayed gastric emptying caused by ACV can be particularly problematic for managing blood sugar.
• Individuals with acid reflux or ulcers: The acidic nature of ACV can worsen symptoms and cause irritation.
• People with low potassium or osteoporosis: High, long-term intake can exacerbate these conditions.
• Patients on certain medications: Those taking diuretics, insulin, or digoxin must consult a doctor due to potential drug interactions.
• Pregnant or breastfeeding women: There is insufficient research to confirm safety during these periods, so moderation is key.

Can ACV Damage Kidneys?

There is limited evidence that moderate ACV consumption harms the kidneys in healthy individuals. However, for those with pre-existing kidney disease, high acid intake is a concern. It is always best for people with chronic kidney issues to consult their doctor.

Safe Alternatives to Drinking ACV

If the downsides outweigh the benefits for you, consider incorporating ACV in other ways:

• Salad Dressings: Mix ACV with oil and herbs for a flavorful dressing.
• Marinades: Use it as a tenderizer and flavoring agent in marinades for meat and vegetables.
• Sauces and Stews: A splash of ACV can brighten up the flavors of sauces and stews.

Frequently Asked Questions

Does drinking apple cider vinegar affect your teeth?

Yes, regularly drinking apple cider vinegar can harm your teeth. Its high acidity can weaken and erode tooth enamel over time, increasing the risk of cavities and sensitivity.

Can apple cider vinegar cause stomach problems?

Yes, excessive or undiluted consumption of apple cider vinegar can cause stomach upset, nausea, heartburn, and bloating due to its high acidity.

Is it safe to drink apple cider vinegar every day?

Drinking a small, diluted amount (1-2 tablespoons) daily is generally considered safe for most people. However, moderation is key, and it should always be diluted in a large glass of water to minimize risks.

Who should avoid drinking apple cider vinegar?

People with certain conditions, including diabetes (especially with gastroparesis), acid reflux, ulcers, low potassium, or osteoporosis, should be cautious or avoid ACV.

Can apple cider vinegar interact with my medication?

Yes, apple cider vinegar can interact with some medications, including insulin, diuretics, and digoxin. It can cause dangerously low blood sugar or potassium levels. Always consult a doctor if you are on medication.

What happens if I drink undiluted apple cider vinegar?

Drinking undiluted ACV can cause serious harm, including chemical burns to the esophagus and severe tooth enamel erosion. It should always be properly diluted.

How can I protect my teeth when drinking apple cider vinegar?

To protect your teeth, always dilute ACV in a large glass of water, drink it through a straw to reduce contact, and rinse your mouth with water afterward. Wait at least 30 minutes before brushing your teeth.