What not to mix with apple cider vinegar?

What You Shouldn’t Mix with Apple Cider Vinegar

Apple cider vinegar (ACV) has gained a reputation as a natural remedy for everything from digestion to weight management. But while it may offer benefits, it’s not without risks—especially when combined with certain medications and supplements.

One major concern is its interaction with diabetes medications, including insulin. ACV can lower blood sugar levels, and when taken alongside drugs designed to do the same, it may cause glucose to drop too low, leading to dizziness, confusion, or worse. That’s why anyone managing diabetes should use ACV with caution—and only under medical guidance.

Another group at risk includes people on heart and blood pressure medications. ACE inhibitors and ARBs (common blood pressure drugs) can increase potassium levels, and ACV may further reduce potassium in the body, potentially disrupting electrolyte balance. The same goes for diuretics—often called "water pills"—which also affect potassium and could lead to dangerous imbalances when combined with vinegar’s acidity.

Even digoxin, a medication used for heart conditions, can be affected. Because ACV may lower potassium, and low potassium intensifies digoxin’s side effects, mixing the two could lead to serious complications.

On the supplement side, caution is needed with licorice root, cassia cinnamon, and horsetail. These can also influence potassium levels or blood sugar, amplifying ACV’s effects in unpredictable ways. For instance, too much cassia cinnamon with ACV could stress the liver or worsen blood sugar swings.

The bottom line? Just because something is “natural” doesn’t mean it’s safe for everyone. If you're on medication or taking herbal supplements, talk to your doctor before making apple cider vinegar a daily habit.