14 Apple Cider Vinegar Scary Side Effects To Know About

Nutritionists get the question all the time: Can drinking apple cider vinegar help with weight loss? But think about it for a sec. If chugging ACV daily and magically dropping two sizes sounds like BS, well, that’s because it is. Sure, if you’re using ACV to replace a calorie-bomb condiment like mayo, then it might help you lose ~some~ weight, says Leslie Bonci, RD, the owner of Active Eating Advice. But that’s the case with any vinegar, not just apple cider.

“Apple cider vinegar is not this magical elixir that’s going to solve all of our problems,” says Amanda Baker Lemein, RD. There’s not much in the way of actual evidence that ACV comes with any of the major health perks that some celebs (*cough*—Kourtney Kardashian—*cough*) swear they’ve experienced by drinking it. While consuming ACV has been touted as a positive health practice that can aid weight loss, regulate blood sugar, and lower cholesterol, it also can cause serious digestive distress in some, notes Eliza Savage, RD.

If you do want to see what all the buzz is about and try it yourself, adding a small daily dose of ACV to your diet probably isn’t dangerous, so the choice is really yours. Here’s everything to know about what you can (and can’t) expect to happen to your body, according to three registered dietitians.


1. You could have serious stomach issues.

“Because vinegar is acidic, some people don’t tolerate it all that well,” says Bonci. Not everyone will experience this issue, but if you have ulcerative colitis, inflammation in your digestive tract, or are just prone to stomach aches, you’ll probably want to steer clear.

The bottom line: Bonci says vinegar—any vinegar—is a great option for adding flavor to food without skewing its caloric value. But remember: It’s not a magic potion, so don’t expect a major transformation.

2. You may experience changes in your bowel movements.

Because ACV is made from fermented apples, it contains pectin, “a soluble dietary fiber that acts as a natural gelling agent,” says Savage. The pectin in ACV can help to bulk up your stool, promote the growth of good bacteria in the gut, and reduce inflammation. Sounds amazing, right?

But people that consume too much ACV could experience diarrhea. “The ACV may pull water into the bowel,” says Savage. This means that your stool may come out watery and more frequently in the form of diarrhea. Needless to say, a not-so-pleasant bathroom experience could await.

3. You could compromise your kidneys.

Another big Q about ACV is whether apple cider vinegar can hurt your kidneys. Lemein cautions people with pre-existing kidney issues from consuming ACV. “There has been some research to show that if you do have any sort of weakened kidneys or immunocompromised kidneys, then consuming anything that is highly acidic is not going to be advised,” says Lemein.

4. You could experience uncomfortable bloating.

If you bloat during your period, then you know just how uncomfortable a swollen tummy can feel. And if you’re not a fan, then the ACV diet might not be for you.

“Consuming apple cider vinegar delays stomach emptying,” says Savage. This reduces the rate at which food leaves the stomach and enters the lower digestive tract, meaning you’ll feel fuller longer. At times delayed stomach emptying can cause temporary weight loss, Savage says. But it can also cause some serious bloating, gas and nausea.

“A healthier diet alternative would be to increase water intake and choose more high fiber non-starchy vegetables,” says Savage.

5. You could worsen acid reflux symptoms.

“Anyone who has acid reflux will want to be cautious of overly acidic foods,” says Lemein. This includes ACV, which falls between a two and a three on an acidity scale of zero to seven (zero being the most acidic).

“I would argue that most people find that introducing more acid into their diet negatively affects their previously occurring issue,” says Savage.

More ACV equals more stomach acid. And more stomach acid can actually heighten or increase the burning sensation for people who already experience heartburn or reflux.

6.You may feel extremely weak.

At the risk of sounding painfully obvious here, if you try to subsist mainly on ACV drinks, you’re going to get too few calories to function. “It really creates that sense of imbalance, big time,” says Bonci.

If you want to start consuming more ACV, Bonci suggests instead having vinegar as part of a meal that also incorporates vegetables, protein, and carbohydrates, ideally as a replacement for a heavier dressing or seasoning. That way, your body will still get the fuel it needs—and you’ll save yourself a few unnecessary calories in the process.

7. Your immune system could take a hit.

There is evidence to suggest that probiotics and healthy gut bacteria translate to a strong immune system. ACV is a fermented liquid, and fermentation holds probiotic properties, so it could be an immunity booster…right? Eh, probably not, says Bonci.

Fermented foods can help increase good bacteria in your gut, she says, and some—like sauerkraut—do come in a vinegar base. But the vinegar alone probably isn’t going to pack the probiotic punch that you need to make a difference in your immune system.

And Bonci says that if you go nuts with the ACV, you could push out other nutrients from your diet, which is actually bad for your immune system.

8. You could lose weight—but only temporarily.

That’s because any weight you lose supposedly from ingesting more ACV would be primarily water weight, notes Bonci. “So when you replace that water, your weight will come back on.”

If you do slim down on an ACV diet, it would be similar to any crash diet—so that rapid weight loss might end up slowing your metabolism and making it harder to shed pounds in the future, Bonci says.

9. Your appetite might increase.

Word on the street is that ACV is an appetite suppressant (FWIW, our writer who tried drinking it daily reported that she didn’t notice a change in how hungry she was). In fact, Bonci says people who drink a lot of diluted ACV (in replacement of, say a snack) might actually end up hungrier because vinegar is so low-cal.

“You feel full for the moment that you’re having it, because you’ve just consumed a gallon of water, but when you pee that out, you’re going to be hungrier, sooner,” she says.

10. Your potassium levels may drop and you may experience bone loss.

Another potential side effect to be aware of is hypokalemia, which occurs when potassium levels drop too low, says Soma Mandal, MD, a board-certified internist at Summit Medical Group in Berkeley Heights, New Jersey. Hypokalemia can lead to cardiac arrhythmia, or an irregular heartbeat.

There’s no proven correlation between ACV and low potassium levels, but one woman in a case study was thought to have experienced this side effect from consuming a lot of ACV over an extended period of time.

A 28-year-old woman who consumed apple cider vinegar for six years experienced low potassium levels, as well osteoporosis (a disease that occurs when the body loses too much and/or produces too little bone, which is otherwise rare in young people), and other blood abnormalities, according to one study. The doctors who treated her believed this was all a result of her over-consumption of ACV.

“When you have low potassium, you can also experience muscle cramps, weakness, and fatigue,” says Dr. Mandal. “This is even more concerning for people who are taking blood pressure medications such as diuretics,” which can also lower potassium.

11. Your tooth enamel may begin to erode.

Diets high in acidic foods, like fruit juices and citrus fruits, have been shown to lead to damaged tooth enamel, studies show. Tooth enamel erosion is definitely something you want to avoid—once it occurs, there’s not much you can do besides cosmetic repair procedures like bonding. Since apple cider vinegar is acidic, overconsumption can lead to dental erosion, too, says Dr. Mandal.

12. You may feel burning in your throat.

The harsh acidity of ACV can also lead to throat and esophageal irritation, says Dr. Mandal. This isn’t just limited to liquid consumption, though. In fact, one study showed that a woman who’d consumed ACV capsules experienced burning in her throat after one of the pills became lodged in there, leading her to deal with difficulty swallowing and pain for six months afterward.

13. You may start to deal with skin irritations and burns.

Some people apply ACV topically, or take ACV baths, in an effort to soothe acne and skin abrasions. But it can lead to skin irritation and chemical burns if you use too much, says Dr. Mandal.

Seriously. An 8-year-old boy received chemical burns when his mom attempted to treat a skin infection by applying apple cider vinegar, according to one case study. Needless to say, if you’re ever unsure as to how you might react to a new skin treatment, consult a dermatologist first.

14. You may experience interactions with certain drugs.

Because apple cider vinegar can lead to delayed stomach emptying, or gastroparesis, says Dr. Mandal, it can be a major problem if you take certain meds that need to pass through your body and be absorbed on a certain timeframe

“Extra caution needs to be taken if you’re taking diuretics, insulin, blood pressure medication and laxatives,” says Dr. Mandal. “This is especially concerning for people with type 1 and 2 diabetes, since gastroparesis can lead to difficulty controlling blood sugar,” she says.

Is there a safe way to consume ACV?

If you’re still interested in consuming ACV for the good benefits it’s touted for, the key is portion control. “Start with one to two teaspoons of diluted ACV with eight ounces of water and progress up to one tablespoon mixed with eight ounces of water,” Savage says. “ACV should always be diluted.”

Dr. Mandal recommends consuming it with a meal, too. “If you decide to start taking ACV, consult your primary care physician to make sure there aren’t any potential complications first,” she says. Always a good idea with any diet change!

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