Apple cider vinegar (ACV) is made from fermented apple juice and is rich in vitamins, minerals, and acids. It is often used for its potential health benefits, including improved digestion, blood sugar control, and weight management. However, due to its acidic nature and effects on metabolism, ACV may interact with several medications, leading to harmful side effects like low blood sugar or low potassium levels.
1. Diabetes and Blood Sugar-Lowering Medications
ACV may lower blood sugar by slowing gastric emptying and increasing carbohydrate absorption. When combined with diabetes medications, it can heighten the risk of hypoglycemia (low blood sugar).
Examples of affected medications:
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Metformin (Glucophage, Glumetza)
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Glipizide (Glucotrol)
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Insulin
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Semaglutide (Ozempic, Wegovy)
Herbs and supplements with similar effects:
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Cinnamon
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Green tea
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Bitter melon (Momordica charantia)
Symptoms of hypoglycemia include weakness, rapid heartbeat, confusion, sweating, hunger, or even loss of consciousness. Discuss with your provider if you experience frequent low blood sugar episodes.
2. Digoxin
Digoxin (Digox, Lanoxin) is used to treat arrhythmias and heart failure. When potassium levels are low, the risk of digitalis toxicity increases, which may be worsened by ACV's effect on potassium levels.
Symptoms of toxicity:
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Vision changes
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Confusion
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Nausea, vomiting, or diarrhea
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Irregular heartbeat
If you're taking digoxin, monitor potassium levels closely under medical supervision.
3. Diuretics
Diuretics ("water pills") help remove excess fluids and can reduce potassium levels. ACV may exacerbate this effect, raising the risk of hypokalemia (low potassium).
Examples:
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Hydrochlorothiazide
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Chlorothiazide (Diuril)
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Furosemide (Lasix)
Symptoms of hypokalemia include fatigue, muscle cramps, and irregular heartbeat. Treatment varies depending on severity and may include oral potassium supplements.
4. Stimulant Laxatives
These laxatives increase intestinal activity and reduce water absorption, which can lead to fluid and electrolyte loss.
Examples:
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Senna
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Bisacodyl (Dulcolax)
Natural supplements with laxative effects:
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Flaxseed
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Gardenia
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Rose hip
Combining stimulant laxatives with ACV may worsen potassium loss and cause or intensify hypokalemia.
5. Herbs and Supplements With Cardiac Glycosides
Cardiac glycoside-containing herbs have similar effects and risks as digoxin. When combined with ACV, they can lead to digitalis toxicity.
Examples:
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Foxglove
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Oleander
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Lily-of-the-valley
As with digoxin, combining these herbs with ACV should be avoided or carefully monitored.
6. Licorice Root
Used in supplements for digestion, menopause, and infections, licorice root can raise blood pressure and lower potassium. Taking it with ACV can increase the risk of hypokalemia.
Consult your provider before using these together.
7. Horsetail
This herb is used for urinary and skin health. It promotes fluid removal and may lead to low potassium levels. Combining horsetail with ACV can compound this effect.
Your provider may suggest potassium monitoring or alternative treatments.
When To See a Healthcare Provider
If you’re taking ACV, talk to your healthcare provider about possible interactions with medications or supplements. Seek medical attention if you notice symptoms of low blood sugar or potassium, such as confusion, fainting, or muscle weakness.
Conclusion
While apple cider vinegar offers potential health benefits, it can interfere with several medications, especially those affecting blood sugar and potassium levels. These include diabetes drugs, diuretics, digoxin, and certain herbs like licorice or horsetail.
Always consult a healthcare provider before starting ACV if you're on medication. Doing so helps avoid serious complications and ensures safe and effective use.
