Apple cider vinegar is fermented juice from green apples. The juice contains several vitamins, minerals, and acids and has been traditionally used for various medical reasons. Potential health benefits of apple cider vinegar include improved skin health, blood sugar levels, and weight management.
Due to its acidic nature and how it works in the body, apple cider vinegar has the potential to interact with other medications you are taking. Medications that may interact with apple cider vinegar include diabetes medications, digoxin, and laxatives.
Apple cider vinegar can lower blood sugar levels in people with diabetes. Research suggests this effect may be because it slows down gastric emptying (how quickly your stomach empties). Apple cider vinegar may also improve how well your body absorbs carbohydrates, which further affects blood sugar levels.
Taking apple cider vinegar with other medications that lower your blood sugar may increase your risk for hypoglycemia (low blood sugar).
Examples of blood sugar-lowering medications include:
- Glucophage, Riomet, or Glumetza (metformin)
- Glucotrol (glipizide)
- Insulin
- Ozempic or Wegovy (semaglutide)
Herbs and supplements that can lower your blood sugar include:
Hypoglycemia occurs when your blood sugar drops below 70 milligrams per deciliter (mg/dL). A normal fasting blood sugar (after not eating for at least 8 hours) is 70-99 mg/dL. Signs of hypoglycemia include feeling weak, fast heart rate, sweating, hunger, confusion, passing out, and seizures.
Low blood sugar is considered an emergency and can often be treated by drinking or eating foods to raise your blood sugar. If you’re frequently experiencing episodes of hypoglycemia, talk with your healthcare provider about ways to prevent low blood sugar.
Digoxin is a medication prescribed to treat heart conditions like atrial fibrillation (a type of arrhythmia, or irregular heartbeat) and heart failure. Brand names include Digox and Lanoxin.
Digitalis toxicity is a dangerous side effect that can occur by having too much digoxin in your body. It can also occur while taking digoxin if you have low potassium levels. Symptoms of digitalis toxicity include:
- Confusion
- Decreased consciousness
- Difficulty breathing
- Fast heartbeat
- Loss of appetite
- Nausea, vomiting, diarrhea
- Vision changes
If you take digoxin and apple cider vinegar, your healthcare provider will closely monitor your digoxin and potassium levels.
Diuretics, also called water pills, treat heart and blood vessel conditions and help your body get rid of extra fluid. Diuretics work by passing water and electrolytes like sodium and potassium through your urine. Examples of diuretics include hydrochlorothiazide, Diuril (chlorothiazide), and Lasix (furosemide).
As stated previously, hypokalemia (low potassium levels) has been reported with high doses of apple cider vinegar. Some diuretics also lower potassium levels. If you take apple cider vinegar with a diuretic that lowers potassium, you are at a higher risk of experiencing hypokalemia.
Hypokalemia occurs once your potassium level is below about 3.5 millimoles per liter (mmol/L) of blood. Symptoms depend on how low your potassium level is and may include:
- Confusion
- Fatigue
- Muscle cramping
- Heart palpitations or abnormal heartbeat
- Muscle weakness or paralysis
Hypokalemia treatment depends on the severity of symptoms and complications you are having. For example, you can have low potassium levels and experience no symptoms at all. This typically does not require any treatment but does need to be monitored.
See a healthcare provider if you experience symptoms. The goal of treatment is to prevent or treat life-threatening complications, replace your potassium levels, and fix the underlying cause of the change. Depending on how low your potassium level is and your symptoms, you can replenish your potassium levels by taking potassium by mouth (orally).
If you are concerned about a drug interaction between a diuretic and apple cider vinegar, talk with your healthcare provider. They will help determine the best treatment option for your health condition.
Laxatives are a group of medications that help promote bowel movements. They are often used to treat constipation and other gastrointestinal health concerns.
Stimulant laxatives are a type of laxative that increases movement in the intestines and decreases how much water your body absorbs from your bowel. Examples of laxatives include senna and Dulcolax (bisacodyl). Supplements that can have a laxative effect include flaxseed, gardenia, and rose hip.
Taking certain laxatives and apple cider vinegar may increase your risk for low potassium levels. Due to the loss of fluids through bowel movements, electrolytes like potassium can be easily removed from the body. Taking apple cider vinegar as well can increase the risk of hypokalemia.
If you are concerned about an interaction between a laxative you are taking and apple cider vinegar, talk with your healthcare provider. They will help determine the best treatment option for your health condition.
Cardiac glycoside herbs and supplements are used to treat heart conditions such as atrial fibrillation or heart failure. These supplements are related to the prescription drug digoxin and have similar side effects. Examples of these herbs include foxglove, oleander, and lily-of-the-valley.
Similar to digoxin, taking high doses of apple cider vinegar with cardiac glycosides can lead to dangerous side effects (digitalis toxicity) related to low potassium levels.
Licorice root is an herbal product used in food and taken as a supplement. The supplement is used to help with conditions such as digestive issues, menopause symptoms, and infections.
When consumed for a long time or in high doses, licorice can increase your blood pressure and lower potassium levels. Taking licorice and apple cider vinegar together may increase your risk for hypokalemia.
Talk with your healthcare provider before taking apple cider vinegar and licorice. They will likely monitor your potassium levels or recommend a different treatment option.
Horsetail is a herb from the Equisetum plant with antioxidant and anti-inflammatory properties. The herb is used to help remove fluids from the body, treat urinary tract infections (UTIs), and improve skin, hair, and bone health.
A potential side effect of horsetail is low potassium levels, likely because it can remove fluid from the body. Taking horsetail and apple cider vinegar may increase your risk for hypokalemia.
Talk to your healthcare provider if you are taking apple cider vinegar and horsetail. They will likely monitor your potassium levels or recommend a different treatment.
If you’re using apple cider vinegar, let your healthcare provider know. They can help you determine if the supplement is safe with other medications, herbs, and supplements you may be taking. Your healthcare provider can also examine whether apple cider vinegar would positively or negatively affect any medical conditions you may have.
See a healthcare provider if you experience signs or symptoms of low blood sugar or low potassium while taking apple cider vinegar. If left untreated, these issues can lead to serious complications and harm.
Apple cider vinegar contains several vitamins, minerals, and acids and has been traditionally used for many medical reasons. Potential health benefits of apple cider vinegar include improved skin health, blood sugar levels, and weight management.
Side effects caused by apple cider vinegar include low blood sugar and low potassium. Due to these side effects, apple cider vinegar has the potential to interact with other medications you are taking. Medications that may interact with apple cider vinegar include diabetes medications, digoxin, and laxatives.
If you are interested in taking apple cider vinegar, discuss any medications or supplements you may be taking with your healthcare provider. They can help you determine if it is safe to take these products together.
