6 Potential Side Effects of Apple Cider Vinegar

Apple cider vinegar is a type of fermented juice made from crushed apples and yeast. It is commonly used in cooking, but it has also traditionally been used for medicinal purposes. But the vinegar doesn't come without side effects. When used over extended periods or in large amounts, it can create health issues, ranging from tooth erosion to indigestion.

To avoid these side effects, it's important to consume no more than 15 milliliters of apple cider vinegar daily, and immediately stop if you begin to notice any adverse effects. You should always contact your healthcare professional with concerns and to find out whether apple cider vinegar is right for you.

A person reading the label of a bottle of apple cider vinegar

Oscar Wong / Getty Images

In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. When choosing a supplement, look for independently tested products and consult a healthcare provider, registered dietician nutritionist (RD or RDN), or pharmacist.

What Is Apple Cider Vinegar?

Apple cider vinegar is a type of fermented juice made from crushed apples and yeast. Making apple cider vinegar leads to the formation of acetic acid. Acetic acid is thought to be the cause of many potential benefits of apple cider vinegar.

It is believed to have antioxidant, antiviral, and antimicrobial capabilities. That acidity can also cause some health concerns.

Side Effects of Apple Cider Vinegar

Apple cider vinegar may be a popular supplement, but, as with most other supplements, using it comes with possible side effects. Side effects associated with apple cider vinegar may be mild or severe.

In general, apple cider vinegar is usually well tolerated in small doses. Large doses are more likely to cause side effects.

These side effects have been reported from using apple cider vinegar.

1. Lower Potassium Levels

When used in large quantities over a long period of time, apple cider vinegar can decrease your potassium levels. Low potassium levels (hypokalemia) pose a risk to the heart's and nervous system's electrical systems, causing signaling issues.

Sometimes hypokalemia has no obvious symptoms, but other times it can result in muscle cramps, fatigue, and even paralysis, among other issues.

2. Bone Loss

There is anecdotal evidence that suggests a possible correlation between the overconsumption of apple cider vinegar and bone loss.

A paper was published detailing health issues found in a patient who had consumed 8 ounces of apple cider vinegar diluted with water every day over the span of six years. She was found to have low potassium levels and was diagnosed with osteoporosis, a rareity in someone as young as the 28-year-old.

Osteoporosis weakens and thins bones, resulting in joint pain, back pain, easily experiencing bone fractures, and height loss or stooping.

More research is needed to truly understand if overconsumption of apple cider vinegar might result in bone loss.

3. Digestive Problems

Even though apple cider vinegar is often used to aid digestion, consuming too much can have the opposite effect, resulting in stomach burning or digestive intolerance.

In a 2021 review of nine studies on the vinegar, only two reported side effects, like stomach burning. That said, indigestion can become painful over time or in extreme cases and is best avoided.

4. Tooth Erosion

When teeth come into contact with apple cider vinegar for long periods of time, one side effect is tooth erosion. Consuming apple cider vinegar daily increases the chances of tooth erosion. Tooth erosion is caused by the acidity of the vinegar. Even diluting 2 tablespoons of vinegar in a cup of water can still lead to tooth wear if consumed daily.

When teeth become eroded, they can appear yellow or transparent, and front teeth look shorter than normal. People dealing with tooth erosion also often face increased heat and cold sensitivity, cracking, denting, and chipping of their teeth, and overall tooth pain. Tooth erosion is irreversible.

Try using apple cider vinegar every other day or every few days instead of every day to avoid tooth erosion.

5. Throat Burns

In extreme cases, some people might experience the rare side effect of apple cider vinegar burning their throat, or in some cases, scarring of the esophagus in children. This is due to its high acidity and has only been experienced when used incorrectly, such as consuming it as part of a cleaner or detergent, as found in a 1994 retrospective analysis of 98 patients.

6. Chemical Burns

Another side effect, also due to the acidity of apple cider vinegar, is chemical burning. Chemical burns can result when very strong concentrations of vinegar are applied to the skin, but reactions can vary depending on the person's sensitivity and the concentration of the vinegar.

Symptoms of a chemical burn might include redness and irritation or blisters in extreme cases. Luckily, most chemical burns don't cause major skin damage.

7. Delayed Stomach Emptying

Some research suggests that apple cider vinegar can cause delayed gastric emptying, slowing down how quickly the food leaves the stomach. Side effects and symptoms of delayed gastric emptying, also called gastroparesis, include heartburn, nausea, bloating, and erratic blood glucose levels.

Because of the effect of gastroparesis on blood glucose levels, people with diabetes should be extra aware of this potential side effect.

Supplements use should be individualized and vetted by a healthcare professional, such as a registered dietician nutritionist (RD or RDN), pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.

Purported Uses of Apple Cider Vinegar


Apple cider vinegar is produced when apple cider is fermented. During this process, bacteria and yeast interact with the sugar naturally found in apples. The final result is apple cider vinegar, which contains acetic acid, a component of all kinds of vinegar.

Apple cider vinegar is believed to support human health in various ways.

Blood Sugar

The acetic acid in apple cider vinegar may help lower blood sugar.

A 2017 research review showed that taking vinegar along with meals lowered both sugar and insulin levels in the blood, two factors often elevated in people with type 2 diabetes. Researchers from the study concluded that vinegar, including apple cider vinegar, has the potential to be used alongside medications and lifestyle changes to manage blood sugar.

A more recent systematic review found that consuming apple cider vinegar decreased both fasting blood sugar and HbA1C, two parameters used to diagnose type 2 diabetes.

Acne and Other Skin Conditions

Some believe that apple cider vinegar can improve acne and other skin conditions, but these claims are mostly unfounded. As an example, a small study found topical apple cider vinegar provided no benefits for people with atopic dermatitis.

Regardless, some people continue to use topical apple cider vinegar for acne and other skin conditions, providing only anecdotal evidence that it works.

Antifungal Properties

One of the overarching claims of apple cider vinegar is that it contains antifungal properties, making it a potential treatment option for a wide range of health conditions.

However, despite a bevy of anecdotal evidence pointing to the antifungal properties of apple cider vinegar, scientific research supporting this claim remains lacking.

An in vitro (test tube) study concluded that apple cider vinegar contains antifungal properties. In the study, apple cider vinegar was found to be a possible therapeutic option for those with a fungus, candida, growing on their dentures.

However, it should be noted that this study was performed in a test tube and should be replicated on humans to strengthen the results.

Heart Health

Emerging research has shown that apple cider vinegar could be useful in improving the health of your heart.

High levels of lipids and cholesterol in the blood are risk factors for heart disease. A systematic review from 2021 found that apple cider vinegar consumption was linked to decreased levels of total cholesterol in the blood. According to the study, apple cider vinegar may block the formation of new fat cells and help remove cholesterol from the body.

Large-scale human trials should be conducted to repeat and confirm these positive results.

How Do I Take Apple Cider Vinegar Safely?

Supplement Facts

  • Active ingredient(s): Acetic acid, polyphenolic compounds
  • Alternate name(s): ACV, cider vinegar, apple vinegar
  • Legal status: Legal and sold over the counter in the United States 
  • Suggested dose: No universal dosage recommendations
  • Safety considerations: Possible side effects include burning and stomach irritation; precautions should be taken

To use apple cider vinegar internally, you can drink diluted apple cider vinegar, add apple cider vinegar to various foods and recipes, or take a supplement. You can also use it topically (on your skin).

In its liquid form, apple cider vinegar comes filtered or unfiltered. The main difference is that unfiltered apple cider vinegar still contains a substance called the "mother." While research is conflicting, the mother is believed to contain probiotics, which are good bacteria for your gut.

There isn't necessarily a recommended dose for taking apple cider vinegar. However, one scientific study found that the greatest benefits were seen at a dose of 15 milliliters or less a day for at least eight weeks. To find the right dose for you, speak with your healthcare provider.

Apple cider vinegar supplements come in gummies, capsules, or tablets. Be sure to read the nutrition label, as some apple cider vinegar supplements contain additional vitamins, minerals, and other ingredients.

Unless told otherwise by your healthcare provider, follow the dosage directions listed on the supplement label. Never take more apple cider vinegar than instructed, as doing so can cause side effects.

Precautions

Apple cider vinegar is considered safe when consumed in small amounts for a short period. However, apple cider vinegar may not be safe if consumed long term or in large doses.

It is unknown if apple cider vinegar is safe to use during pregnancy or lactation. Therefore, people who are pregnant or breastfeeding should consume no more than what's in food amounts.

Apple cider vinegar is believed to be safe for children, but parents should take precautions and only provide recommended doses. Keep apple cider vinegar out of the reach of small children to prevent accidental overconsumption.

People with low potassium should avoid using apple cider vinegar as it may lower potassium levels further.

Interactions

Apple cider vinegar may interact with some medications, including:

People taking these medications should be extra cautious when using apple cider vinegar and should speak with a healthcare provider to determine if it's safe.

Summary

Apple cider vinegar is a popular product that has been used for many years, but when used for a long period of time or in large dosages—or when dealing with a highly concentrated form of the vinegar—there are risks.

Apple cider vinegar's side effects range from indigestion to tooth erosion and more.

If you’re considering using apple cider vinegar for any health purpose, speak with your healthcare provider to determine if it’s right for you.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Apple cider vinegar.

  2. Gopal J, Anthonydhason V, Muthu M, et al. Authenticating apple cider vinegar's home remedy claims: antibacterial, antifungal, antiviral properties and cytotoxicity aspect. Nat Prod Res. 2019;33(6):906-910. doi:10.1080/14786419.2017.1413567

  3. Karl Lhotta; Günther Höfle; Rudolf Gasser; Gerd Finkenstedt. Hypokalemia, Hyperreninemia and Osteoporosis in a Patient Ingesting Large Amounts of Cider Vinegar. Nephron (1998) 80 (2): 242–243.

  4. Hadi A, Pourmasoumi M, Najafgholizadeh A, Clark CCT, Esmaillzadeh A. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trialsBMC Complement Med Ther. 2021;21(1):179. doi:10.1186/s12906-021-03351-w

  5. Anderson S, Gonzalez LA, Jasbi P, Johnston CS. Evidence that daily vinegar ingestion may contribute to erosive tooth wear in adults. J Med Food. 2021;24(8):894-896. doi:10.1089/jmf.2020.0108

  6. Nuutinen M, Uhari M, Karvali T, Kouvalainen K. Consequences of caustic ingestions in childrenActa Paediatr. 1994;83(11):1200-1205. doi:10.1111/j.1651-2227.1994.tb18281.x.

  7. H Liljeberg & I Björck. Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. European Journal of Clinical Nutrition volume 52, pages368–371 (1998)

  8. MedlinePlus. Apple cider vinegar.

  9. Shishehbor F, Mansoori A, Shirani F. Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Res Clin Pract. 2017;127:1-9. doi:10.1016/j.diabres.2017.01.021

  10. Hadi A, Pourmasoumi M, Najafgholizadeh A, Clark CCT, Esmaillzadeh A. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trialsBMC Complement Med Ther. 2021;21(1):179. doi:10.1186/s12906-021-03351-w

  11. Luu LA, Flowers RH, Gao Y, et al. Apple cider vinegar soaks do not alter the skin bacterial microbiome in atopic dermatitisPLoS One. 2021;16(6):e0252272. doi:10.1371/journal.pone.0252272

  12. Mota AC, de Castro RD, de Araújo Oliveira J, de Oliveira Lima E. Antifungal activity of apple cider vinegar on candida species involved in denture stomatitisJ Prosthodont. 2015;24(4):296-302. doi:10.1111/jopr.12207

  13. Atik D, Atik C, Karatepe C. The effect of external apple vinegar application on varicosity symptoms, pain, and social appearance anxiety: a randomized controlled trial. Evid Based Complement Alternat Med. 2016;6473678. doi:10.1155/2016/6473678

  14. Aykın E, Budak NH, Güzel-Seydim ZB. Bioactive components of mother vinegar. J Am Coll Nutr. 2015;34(1):80-89. doi: 10.1080/07315724.2014.896230

Headshot

By Brittany Lubeck, MS, RDN
Lubeck is a registered dietitian and freelance nutrition writer with a master's degree in clinical nutrition.