Who Cannot Drink Apple Cider Vinegar? The Essential Guide

December 9, 2025 •

4 min read

An estimated 50% of people who try apple cider vinegar do not understand its significant health contraindications, according to recent wellness industry polling. It is crucial to understand who cannot drink apple cider vinegar to avoid serious side effects and dangerous medication interactions.

Quick Summary

This article details specific health conditions, such as chronic kidney disease and gastroparesis, and medications, including diuretics and insulin, that make apple cider vinegar unsafe. It provides guidance on who should avoid ACV to prevent risks like enamel erosion and electrolyte imbalances, urging caution and dilution for safe consumption.

Key Points

Diabetes Management: Those on insulin or other diabetes medications must avoid ACV due to the risk of dangerously low blood sugar.
Chronic Kidney Disease: Individuals with impaired kidney function should not consume ACV as it can exacerbate metabolic acidosis and strain the kidneys.
Digestive Issues: People with gastroparesis, acid reflux, or ulcers should steer clear of ACV, as its acidity can worsen symptoms.
Medication Interactions: ACV can interact with diuretics, digoxin, and laxatives, potentially causing low potassium levels or other serious complications.
Dental Health: Anyone with sensitive teeth or concerns about enamel erosion should be cautious, as ACV's high acidity can damage tooth enamel over time.
Pregnancy and Breastfeeding: Due to a lack of safety research, pregnant or breastfeeding women should avoid supplemental ACV.
Undiluted Consumption: Never drink ACV undiluted, as it can cause burns and irritation to the throat and esophagus.

Understanding the Risks of Apple Cider Vinegar Consumption

While popularized as a health tonic, apple cider vinegar (ACV) is not suitable for everyone and can pose significant health risks for certain individuals. The highly acidic nature of ACV, combined with its potential to alter mineral and blood sugar levels, makes it a substance that requires careful consideration. For some people, particularly those with pre-existing conditions or on specific medications, the dangers can outweigh any perceived benefits. This guide explores the key reasons why certain populations should avoid consuming apple cider vinegar and highlights the potential negative consequences.

Chronic Kidney Disease and Metabolic Acidosis

Individuals with chronic kidney disease (CKD) should exercise extreme caution or completely avoid apple cider vinegar. Compromised kidneys struggle to remove excess acid from the blood. Introducing more acid from ACV can exacerbate a condition called metabolic acidosis, which is an imbalance in the body's pH. This can put an unhealthy strain on the kidneys and worsen the underlying condition. Therefore, anyone with impaired kidney function should avoid ACV unless explicitly cleared by a nephrologist. While some claim ACV can cleanse the kidneys, there is no scientific evidence to support this; healthy kidneys are self-cleaning. The risk is particularly high for those in later stages of CKD (Stage 4 or 5).

Diabetes and Medication Interactions

For individuals with diabetes, consuming apple cider vinegar requires careful medical supervision, especially for those on medications. ACV can lower blood sugar levels, which, when combined with insulin or other glucose-lowering drugs like metformin or glipizide, can significantly increase the risk of hypoglycemia (dangerously low blood sugar). Symptoms of hypoglycemia can include dizziness, confusion, and a rapid heartbeat. Furthermore, ACV can delay stomach emptying, a condition known as gastroparesis, which can complicate blood sugar management for diabetics. It is crucial to consult a healthcare provider to monitor blood sugar closely before adding ACV to your routine.

Pre-existing Digestive Disorders

The highly acidic nature of apple cider vinegar can be irritating or even damaging to the digestive tract. Individuals with certain gastrointestinal conditions should avoid it altogether. The most prominent examples include:

Gastroparesis: ACV can slow down stomach emptying, which is the defining characteristic of this condition. For those with gastroparesis, ACV can worsen symptoms like bloating, nausea, and heartburn, making it harder to regulate insulin and blood sugar.
Acid Reflux (GERD): While some anecdotal claims suggest ACV can help with acid reflux, its high acidity can often exacerbate symptoms, particularly for those with a compromised esophageal sphincter. It can further irritate the esophagus, potentially leading to inflammation or esophageal burns.
Stomach Ulcers: The corrosive nature of ACV can aggravate existing stomach or duodenal ulcers, delaying healing and increasing pain.

Those Taking Certain Medications

Apple cider vinegar has several documented interactions with common medications that can lead to serious health complications. Always consult a doctor or pharmacist before combining ACV with any prescription drugs.

Diuretics: Also known as 'water pills,' diuretics can cause potassium levels to drop. Since large amounts of ACV can also reduce potassium levels, combining the two increases the risk of hypokalemia (low potassium). Hypokalemia can lead to dangerous side effects such as muscle cramps, weakness, and irregular heartbeats.
Digoxin (Lanoxin): This medication is used to treat heart conditions. As with diuretics, ACV-induced low potassium can increase the risk of digitalis toxicity, a serious side effect of digoxin.
Insulin and Other Diabetes Medications: As mentioned, ACV can enhance the blood sugar-lowering effect of these medications, leading to a risk of hypoglycemia.
Laxatives: Especially stimulant laxatives, can cause electrolyte imbalances, particularly low potassium. The combination with ACV amplifies this risk.

Risks for Pregnant or Breastfeeding Women

There is a significant lack of reliable information regarding the safety of consuming supplemental apple cider vinegar during pregnancy or breastfeeding. While small amounts used in food are likely safe, the medicinal use of ACV is not well-researched for this population. As a precautionary measure, pregnant and nursing women are generally advised to avoid consuming large amounts or taking ACV as a supplement.

Table of Potential ACV Risks vs. Benefits


Feature	Potential Benefits (with caution)	Potential Risks (for some individuals)
Blood Sugar	May improve insulin sensitivity and lower blood sugar after meals.	Can cause severe hypoglycemia when combined with diabetes medication.
Digestion	Anecdotal reports of easing mild indigestion.	Can worsen acid reflux, gastroparesis, and stomach ulcers.
Nutrient Levels	Can help absorption of minerals and vitamins.	Large amounts can lower potassium levels (hypokalemia).
Weight Management	May curb appetite and support weight loss.	Excessive intake can cause nausea and digestive upset.
Dental Health	N/A	High acidity causes tooth enamel erosion, even when diluted.

Conclusion

While apple cider vinegar is often praised as a natural health remedy, it is not a one-size-fits-all solution. The acidic nature of ACV can cause or exacerbate serious health problems in individuals with chronic kidney disease, diabetes, and various digestive disorders. Furthermore, it can interact dangerously with several common medications. Before incorporating ACV into your daily routine, it is essential to consider your personal health profile and existing medication regimen. Diluting ACV and starting with very small amounts can reduce some risks, but consulting a healthcare professional is the most prudent step for anyone with pre-existing conditions. For those with healthy bodies, moderate use as part of a balanced diet is generally safe, but the potential side effects should still be respected.

Final Reminder

This article is for informational purposes and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for personalized recommendations regarding your diet and health, especially if you have chronic conditions or take regular medications. https://www.webmd.com/diet/apple-cider-vinegar-and-your-health

Frequently Asked Questions

People with diabetes, especially those on insulin or other blood sugar-lowering medications, must be cautious because apple cider vinegar can significantly lower blood sugar levels. This combination can increase the risk of severe hypoglycemia (dangerously low blood sugar) and requires careful medical supervision.

Yes, it can be harmful. For those with chronic kidney disease, the kidneys have a hard time removing excess acid from the blood. The added acid from ACV can worsen metabolic acidosis and put dangerous strain on the kidneys.

Yes, apple cider vinegar can interact with several medications, including diuretics (water pills), insulin, certain heart medications like digoxin, and some laxatives. These interactions can lead to dangerously low potassium levels or blood sugar.

No, it is generally not recommended. Despite anecdotal claims, the high acidity of apple cider vinegar can often worsen acid reflux and GERD symptoms by further irritating the esophagus. Always consult a doctor before trying it for this condition.

Apple cider vinegar's high acidity can erode tooth enamel over time, even when diluted. This can increase tooth sensitivity and the risk of cavities. Using a straw and rinsing your mouth after consumption can help, but does not eliminate the risk entirely.

There is a lack of reliable safety information regarding the use of apple cider vinegar as a supplement during pregnancy or breastfeeding. To remain on the safe side, it is best to stick to food amounts and avoid large quantities or supplements.

Yes, drinking undiluted apple cider vinegar is highly risky. It can cause serious irritation and burns to the throat and esophagus due to its concentrated acidity. It also accelerates the erosion of tooth enamel.

Gastroparesis is a condition involving delayed stomach emptying, which is a particular concern for people with diabetes. ACV can further slow down gastric emptying, worsening symptoms like bloating, nausea, and affecting blood sugar regulation.