What are the side effects of drinking apple cider vinegar and lemon juice?

December 22, 2025 •

4 min read

According to the National Capital Poison Center, applying vinegar directly to the skin can cause burns and irritation. When consumed, the highly acidic combination of apple cider vinegar and lemon juice also poses potential health risks that are important to understand before making it a regular part of your diet.

Quick Summary

Potential health risks associated with drinking a mixture of apple cider vinegar and lemon juice include damage to tooth enamel, gastrointestinal distress, and nutrient imbalances. Guidance on safer consumption practices is provided, and individuals who should be particularly cautious are identified.

Key Points

Tooth Enamel Erosion: The combination's high acidity can seriously damage and weaken tooth enamel over time, leading to sensitivity and decay.
Digestive Issues: Many users experience gastrointestinal problems like nausea, bloating, heartburn, or diarrhea due to the acidic nature of the mixture.
Delayed Gastric Emptying: ACV can slow down stomach emptying, which may cause prolonged fullness but also increase bloating, especially for those with diabetes.
Low Potassium Levels: Excessive long-term use can lower potassium levels in the body, potentially leading to muscle weakness and heart rhythm irregularities.
Drug Interactions: The mixture can interfere with certain medications, including diabetes drugs, diuretics, and heart medication.
Potential for Throat Burns: Consuming undiluted ACV and lemon juice can cause irritation or burns to the esophagus and throat lining.
Importance of Dilution and Moderation: To minimize risks, always dilute the mixture and consume it in moderation.

The combination of apple cider vinegar (ACV) and lemon juice has become a popular home remedy, often touted for its supposed health benefits, such as weight loss and improved digestion. However, the highly acidic nature of both ingredients can lead to significant side effects, especially with long-term or excessive use. Understanding these risks is crucial for anyone considering adding this mixture to their daily routine.

Dental Damage and Erosion

One of the most immediate and irreversible risks of regularly consuming a highly acidic beverage like diluted ACV and lemon juice is damage to tooth enamel. Both ingredients contain strong acids—acetic acid in ACV and citric acid in lemon juice—that can weaken and erode the protective outer layer of your teeth.

Weakened Enamel: The acid softens tooth enamel, making it more susceptible to damage from physical abrasion, such as brushing.
Increased Sensitivity: As enamel erodes, the sensitive inner layers of the teeth can become exposed, leading to increased sensitivity to hot, cold, or sweet foods and drinks.
Tooth Decay: Eroded enamel leaves teeth more vulnerable to cavities and decay, requiring potential dental work.
Discoloration: The underlying yellowish dentin can become more prominent as enamel wears away, changing the appearance of your teeth.

Gastrointestinal and Digestive Problems

For some individuals, particularly those with pre-existing conditions, the high acidity of this drink can cause or worsen digestive issues.

Irritation and Burns: Undiluted or concentrated mixtures can irritate the esophagus and stomach lining, potentially leading to throat burns or irritation. A case study noted a teenager developed esophageal damage and blood vomiting after consuming concentrated ACV.
Nausea and Bloating: The mixture can cause indigestion, nausea, and bloating in some people. While often recommended for digestion, it can paradoxically cause discomfort for those with sensitive stomachs.
Delayed Stomach Emptying: Studies have suggested that ACV can delay gastric emptying, a condition also known as gastroparesis. This can cause bloating, gas, and nausea, and is a particular concern for people with diabetes, as it can make managing blood sugar more difficult.
Worsened Acid Reflux: People with acid reflux or GERD may find their symptoms aggravated by adding more acid to their diet.

Nutrient Depletion and Bone Health

Excessive, long-term consumption of ACV, especially in large amounts, has been linked to concerning effects on nutrient levels and bone density.

Low Potassium Levels: A study reported that a woman who consumed a large amount of diluted ACV daily over six years developed low potassium levels (hypokalemia), which can affect heart and nerve function. The combination of ACV with certain medications, like diuretics, can further lower potassium levels.
Bone Loss: The case study mentioned above also indicated that the woman developed osteoporosis at a young age, suggesting a possible link between chronic ACV overuse and bone density issues. More research is needed in this area, but it highlights the potential for systemic effects from long-term, high-amount consumption.

Drug Interactions and Other Risks

ACV and lemon juice can interact with various medications and may not be suitable for everyone.

Blood Sugar Management: ACV can affect blood sugar levels, which is a concern for people on diabetes medication, as it could cause blood sugar to drop too low. Close monitoring is essential.
Diuretics and Laxatives: The mixture can interact with diuretics and laxatives, potentially lowering potassium levels to a dangerous degree.
Kidney Issues: The kidneys process excess acid, and overuse of ACV may be detrimental for individuals with pre-existing kidney disease, as they may be unable to handle high acid levels.

Comparison Table: Risks of Regular vs. Occasional Consumption


Feature	Regular (Daily) Consumption	Occasional (Infrequent) Consumption
Dental Health	High risk of enamel erosion, sensitivity, and decay.	Minimal risk, especially when consumed diluted.
Digestive System	Increased risk of irritation, nausea, bloating, and worsened reflux.	Low risk; generally tolerated well by most people.
Nutrient Levels	Long-term risk of low potassium levels (hypokalemia) and potential bone density issues.	Very low risk of nutrient depletion.
Medication Interaction	Higher likelihood of interactions with diabetes, heart, and diuretic medications.	Minimal to no risk of interaction.
Risk Group Suitability	Unsuitable for individuals with kidney disease, diabetes, or digestive issues.	Generally suitable for healthy individuals.

How to Mitigate Risks and Consume Safely

If you choose to drink apple cider vinegar and lemon juice, follow these guidelines to minimize potential harm:

Always Dilute: Never drink the mixture undiluted. Mix ACV with a substantial amount of water. Lemon juice should also be diluted.
Use a Straw: Drinking through a straw can help bypass your teeth, reducing direct contact with the acidic liquid and protecting your enamel.
Rinse Your Mouth: After consuming, rinse your mouth with plain water to help neutralize the acid and minimize its effect on your teeth. Wait at least 30 minutes before brushing your teeth, as brushing weakened enamel can cause further damage.
Consume in Moderation: Limit consumption and consider taking breaks or only consuming it infrequently.
Listen to Your Body: If you experience any negative side effects, such as stomach upset, nausea, or throat irritation, stop consuming the mixture immediately.
Consult a Professional: Always speak with a healthcare provider before adding this to your diet, especially if you have pre-existing health conditions or take medication.

Conclusion

While the combination of apple cider vinegar and lemon juice is often marketed as a health elixir, the risks associated with its high acidity are significant and should not be ignored. Potential side effects include severe dental erosion, gastrointestinal distress, and metabolic issues like low potassium. For many, the benefits may not outweigh these risks, and a balanced diet with proper hydration offers safer and more proven health advantages. Adopting safe practices like dilution and moderation is crucial for those who choose to consume it. Ultimately, listening to your body and consulting a healthcare professional are the most important steps to ensure your well-being.

Here is some more information about vinegar's general effects on the body.

Frequently Asked Questions

Yes, daily consumption can be harmful, particularly for your tooth enamel and digestive system, due to the high acidity. It's best to consume it in moderation and with proper precautions.

You can protect your teeth by always diluting the mixture with plenty of water, using a straw to minimize contact with teeth, and rinsing your mouth with plain water afterward.

Individuals with conditions like acid reflux, kidney disease, diabetes, low potassium levels, or osteoporosis, as well as those on certain medications, should avoid or consult a doctor before using.

While anecdotal evidence and some studies suggest potential weight management benefits, they are not a magic solution and do not guarantee weight loss without side effects. The risks, especially for dental and digestive health, are still present.

For some, the high acidity can cause stomach upset, gas, and bloating. ACV can also delay gastric emptying, which may worsen bloating.

Long-term effects from excessive consumption can include severe tooth enamel erosion, low potassium levels (hypokalemia), potential bone loss, and irritation of the esophagus and stomach lining.

For digestive support and general wellness, opt for a balanced diet rich in whole foods, stay hydrated with plain water, and include fermented foods or probiotics in your diet.

It is generally advised to consume ACV diluted in water. Consulting a healthcare professional can help determine an appropriate intake based on individual health needs.