Apple Cider Vinegar Side Effects: Teeth, Throat and Medicines
What published reports say about apple cider vinegar and teeth, the throat and food pipe, blood potassium and diabetes, and where the sources we read stop.
Content last updated . This page has not been medically reviewed.
Safety first. Natural products can cause side effects and interact with medicines. Read natural ingredient safety before you use anything on this page.
Urgent first. Vinegar is an acid. If someone has swallowed vinegar or a vinegar tablet and has pain in the throat, chest or belly, trouble swallowing, drooling, vomiting or trouble breathing, call Poison Help at 1-800-222-1222 (US) or 911 for collapse or breathing trouble. Other countries are listed on Poison Help by Country.
What this page covers
Apple cider vinegar (ACV) is a fermented drink made from apples (Malus domestica (Suckow) Borkh., the fruit it is made from). [1] This page collects the safety reports we could read. It is not a statement that ACV is dangerous for everyone, and it does not say it is harmless. For the benefit side, see Apple Cider Vinegar: Evidence, Teeth, Throat and Medicine Cautions and what trials found for weight and blood sugar.
What the sources found
| Question | What the source found | Type and strength of evidence |
|---|---|---|
| Teeth | In a laboratory study, human enamel slices soaked in several vinegars for up to 8 hours lost minerals, and the amount depended on the vinegar. The authors warned that results in a mouth may differ. [2] | Laboratory (not people); preclinical |
| Teeth, general | The American Dental Association says frequent acidic drinks, and natural acidic fruit juice, may increase the risk of erosion, and lists rinsing with water afterward. [3] It adds that there is some evidence excessive use of vinegar-based dressings may increase erosion. [3] | Professional body summary |
| Throat and food pipe | A case report describes a woman who drank one tablespoon of white vinegar and had a second-degree caustic injury of the food pipe (oesophagus). [4] | Single case report |
| Tablets | A case of food-pipe injury was linked to apple cider vinegar tablets. The authors then tested eight tablet products and found large differences in pH, acid content and label claims. [5] | Case report plus product testing |
| Blood potassium and bones | A case report describes low potassium, high renin and osteoporosis in a patient who ingested large amounts of cider vinegar. [6] | Single case report (title only read) |
| Stomach emptying in type 1 diabetes | In 10 people with type 1 diabetes and gastroparesis (slow stomach emptying), ACV slowed emptying further. The authors said this might be a disadvantage for blood sugar control. [7] | Small crossover trial, 10 people |
Medicines: what we can and cannot say
- Diabetes medicines. The gastroparesis trial above gave people 30 mL of ACV in water daily for two weeks. The authors noted that delayed emptying can cause poor blood sugar control, especially with mealtime diabetes treatment. [7] Pooled trials also found ACV tended to lower fasting glucose. [8] We did not find a regulator or review that lists ACV with specific diabetes medicines, so we cannot say a particular combination is safe or unsafe. See Supplements and Diabetes Medicines.
- Water pills (diuretics) and potassium. The only potassium source we read is the single case report above. Proper evidence not found for a documented ACV and diuretic interaction. We searched PubMed for ACV, vinegar, potassium, diuretic and adverse effects, and looked for NCCIH, MedlinePlus and NHS pages on ACV (none was readable). Anyone on a diuretic or with kidney disease should ask a pharmacist. See also potassium.
- How interactions are rated. How Interactions Work explains the difference between documented, reported and theoretical.
Gaps and limits
- Pregnancy, breastfeeding, children, older adults, and liver or kidney disease: not described in the sources we read for ACV drinks. Lack of evidence is not proof of safety.
- Acid reflux: the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) lists acidic foods among things commonly linked to reflux symptoms, naming citrus and tomatoes; it does not name vinegar. [9]
- Before surgery, tell the surgical team about everything you take, as NCCIH advises for supplements. [10] See Supplements Before Surgery.
- Product quality varies. FDA does not test dietary supplements before they are sold. [11]
What a reader can do
Ask a pharmacist or clinician whether ACV fits with your medicines, especially diabetes medicines, water pills, or if you have kidney disease or slow stomach emptying. Do not swallow vinegar to "dislodge" something stuck in the throat; the Hong Kong report strongly discouraged that. [4]
Frequently asked questions
Can apple cider vinegar damage teeth?
In a laboratory study, several vinegars removed minerals from human enamel slices. [2] The American Dental Association links frequent acidic drinks with erosion. [3] We did not read a trial in people testing ACV specifically.
Can apple cider vinegar burn the throat?
A case report documented a caustic injury to the food pipe after one tablespoon of white vinegar, and another report described injury linked to ACV tablets. [4] [5]
Does apple cider vinegar interact with diabetes medicines?
We did not find an official interaction listing. A small trial found ACV slowed stomach emptying in type 1 diabetes with gastroparesis. [7] Ask a pharmacist.
Does apple cider vinegar lower potassium?
One case report describes low potassium after very large intake. [6] We found no trial or regulator statement, so we cannot say how common this is.
Who should check with a clinician first?
People who take diabetes medicines or diuretics, have kidney disease, slow stomach emptying or reflux, or are pregnant or breastfeeding. The sources we read do not cover every group, so ask.
References
- GBIF Backbone Taxonomy: Malus domestica (Suckow) Borkh., species record 3001244. Read 2026-10-23.
- In vitro study on dental erosion caused by different vinegar varieties using an electron microprobe, Clin Lab 2014, PubMed 24839821. Read 2026-10-23.
- Dental Erosion, American Dental Association. Read 2026-10-23.
- Corrosive oesophageal injury following vinegar ingestion, Hong Kong Med J 2002, PubMed 12376715. Read 2026-10-23.
- Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products, J Am Diet Assoc 2005, PubMed 15983536. Read 2026-10-23.
- Hypokalemia, hyperreninemia and osteoporosis in a patient ingesting large amounts of cider vinegar, Nephron 1998, PubMed 9736833. Only the title and record were available to read. Read 2026-10-23.
- Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study, BMC Gastroenterol 2007, PubMed 18093343. Read 2026-10-23.
- The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials, BMC Complement Med Ther 2021, PubMed 34187442. Read 2026-10-23.
- Eating, Diet, & Nutrition for GER & GERD, NIDDK (NIH). Read 2026-10-23.
- Using Dietary Supplements Wisely, NCCIH (NIH). Read 2026-10-23.
- Questions and Answers on Dietary Supplements, US Food and Drug Administration. Read 2026-10-23.