Apple cider vinegar is the fermented juice of green apples. The juice contains several vitamins, minerals and acids and is traditionally used for various medicinal reasons. Potential health benefits of apple cider vinegar include improved skin health, blood sugar levels, and weight control.
Because of its acidic nature and the way it works in the body, apple cider vinegar has the potential to interact with other medications you take. 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 that this effect may be because it slows gastric emptying (how quickly your stomach empties). Apple cider vinegar can also improve how well your body absorbs carbohydrates, which further affects your blood sugar levels.
Taking apple cider vinegar with other medicines that lower blood sugar can increase the risk of hypoglycemia (low blood sugar).
Examples of blood sugar-lowering drugs include:
- Glucophage, Riomet, or Glumetza (metformin)
- Glucotrol (Glipizide)
- Insulin
- Ozempic or Vegovi (semaglutide)
Herbs and supplements that can lower blood sugar include:
Hypoglycemia occurs when your blood sugar drops below 70 milligrams per deciliter (mg/dL). 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, fainting, and seizures.
Low blood sugar is considered an emergency and can often be treated by drinking or eating foods that raise blood sugar. If you experience frequent episodes of hypoglycemia, talk to your doctor about ways to prevent low blood sugar.
Digoxin is a drug prescribed to treat heart conditions such as atrial fibrillation (a type of arrhythmia or irregular heartbeat) and heart failure. Brands include Digok and Lanokin.
Digitalis toxicity is a dangerous side effect that can occur if you have 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
- Reduced consciousness
- Shortness of breath
- Rapid heartbeat
- Loss of appetite
- Nausea, vomiting, diarrhea
- The vision is changing
If you take digoxin and apple cider vinegar, your healthcare provider will monitor your digoxin and potassium levels closely.
Diuretics, also called water pills, treat heart and blood vessel conditions and help your body get rid of excess fluid. Diuretics work by allowing water and electrolytes such as sodium and potassium to pass through the urine. Examples of diuretics include hydrochlorothiazide, Diuril (chlorothiazide), and Lasik (furosemide).
As noted earlier, hypokalemia (low potassium) has been reported with high doses of apple cider vinegar. Some diuretics also decrease potassium levels. If you take apple cider vinegar with a diuretic that lowers potassium, there is a higher risk of hypokalemia.
Hypokalemia occurs when the potassium level is below about 3.5 millimoles per liter (mmol/L) of blood. Symptoms depend on how low the potassium level is and may include:
- Confusion
- Fatigue
- Muscle cramps
- Palpitations or abnormal heartbeats
- Muscle weakness or paralysis
Treatment for hypokalemia depends on the severity of your symptoms and the complications you have. For example, you can have low potassium levels and experience no symptoms at all. This usually does not require any treatment, but it needs to be monitored.
See a doctor if you experience symptoms. The goal of treatment is to prevent or treat life-threatening complications, replace potassium levels, and eliminate the underlying cause of the change. Depending on how low your potassium level is and your symptoms, you can replenish your potassium level by taking potassium by mouth (oral).
If you are concerned about drug interactions between diuretics and apple cider vinegar, talk to your doctor. They will help you determine the best treatment option for your medical condition.
Laxatives are a group of medications that help promote bowel movements. They are often used to treat constipation and other gastrointestinal health problems.
Stimulant laxatives are a type of laxative that increases bowel movement and decreases the amount of water your body absorbs from the bowels. Examples of laxatives include senna and Dulcolac (bisacodyl). Supplements that may have a laxative effect include flaxseed, gardenia, and pomegranate.
Taking certain laxatives and apple cider vinegar can increase the risk of low potassium levels. Due to fluid loss through bowel movements, electrolytes such as potassium can be easily removed from the body. Taking apple cider vinegar may also increase the risk of hypokalemia.
If you’re concerned about an interaction between the laxatives you’re taking and apple cider vinegar, talk to your doctor. They will help you determine the best treatment option for your medical 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 plants are 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) associated with low potassium levels.
Licorice root is a plant product used in food and taken as a supplement. The supplement is used to help with conditions such as digestive problems, menopausal symptoms and infections.
When consumed over a long period of time or in large doses, licorice can increase your blood pressure and decrease your potassium levels. Taking licorice and apple cider vinegar together may increase the risk of hypokalemia.
Talk to your healthcare provider before taking apple cider vinegar and licorice. They will likely monitor your potassium levels or recommend another treatment option.
Horsetail is an herb from the Equisetum plant with antioxidant and anti-inflammatory properties. The herb is used to remove fluid from the body, treat urinary tract infections (UTIs), and improve skin, hair, and bone health.
A potential side effect of horsetail is low potassium, possibly because it can remove fluid from the body. Taking horsetail and apple cider vinegar may increase the risk of 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 use apple cider vinegar, tell your doctor. 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 investigate whether apple cider vinegar would have a positive or negative effect on any medical conditions you have.
See your doctor if you experience signs or symptoms of low blood sugar or low potassium while taking apple cider vinegar. If left untreated, these problems can lead to serious complications and harm.
Apple cider vinegar contains several vitamins, minerals and acids and has traditionally been used for many medicinal reasons. Potential health benefits of apple cider vinegar include improved skin health, blood sugar levels, and weight control.
Side effects caused by apple cider vinegar include low blood sugar and low potassium. Because of 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 doctor. They can help you determine if it is safe to take these products together.