Is consuming vinegar to excess dangerous?

June 23, 2006

Dear Cecil:

I enjoy spreading lots of vinegar on my salads and other foods. I really think this makes my food taste so much better. My wife keeps pestering me to stop using so much vinegar, contending that the acetic acid will hurt my digestive system. So for the sake of family harmony: Is consuming so much vinegar bad for my health? How much is too much? I have been enjoying vinegar for many years (decades) without any problems and would like to continue.

I'm pretty old-school in culinary matters--while I admit a little balsamic has its place in salad dressing, my main thought about vinegar is that it's what you use when you're out of Windex. However, times being what they are, I knew there was bound to be a vinegar fan club. Sure enough, I find enthusiasts recommending everything from chugging cold vinegar first thing in the morning to warm vinegar enemas. By comparison to some of these people, Bernie, your devotion to vinegar borders on the prim, and I'm guessing that if sipping the stuff for 20-plus years hasn't burned holes in your gullet it probably won't. Still, here's what could happen if you ever decide to really go nuts.

The main active ingredient in vinegar is acetic acid, which is formed when certain bacteria oxidize ethyl alcohol. You can make vinegar from just about anything with alcohol in it, such as wine, apple cider, or fermented rice or malt. Acetic acid is a pretty good antiseptic, cleaner, and solvent that you normally wouldn't think about drinking, but at low levels your body can tolerate it. The reported 50 percent lethal oral dose for acetic acid (for those dozing last time this came up, that means the amount that kills half the party) is about 3,310 milligrams per kilogram of body weight. Scaling that up to a 70-kilo human, we get an LD-50 of about 232 grams, or just over half a pound. Given that most vinegar is less than 10 percent acetic acid by volume, you'd have to toss back more than a half gallon to reach the fatal threshold. Not likely, I suppose, but some have come close. A few gleanings from the journals:

  • A German report tells of a woman who attempted suicide by drinking about 400 milliliters of 25 percent acetic acid--roughly the same amount you'd find in a quart of strong vinegar. The result wasn't pretty--hemolysis (rupture of red blood cells), kidney failure, and severe internal burns. She recovered, but from the standpoint of confirming the above projected LD-50 (some have caviled that my estimates in this regard are too casual), I note that my number is apparently in the ballpark and if anything is too high--the authors claim the amount the woman drank is normally lethal.
  • From Hong Kong we learn of a woman who thought she had a piece of crab shell stuck in her throat and drank rice vinegar to soften it up--evidently a soft-headed folk remedy in those parts. She suffered caustic burns of the esophagus, and no, the crab shell (if that's what it was) didn't dissolve.
  • A report from Austria tells of a cider vinegar fan who developed hypokalemia (low potassium levels), hyperreninemia (a condition caused by overactive kidneys that can lead to high blood pressure and other problems), and osteoporosis. A physician friend of mine has seen hypokalemia in a patient who took cider vinegar as a health supplement.

What about those vinegar pills the cool kids are popping nowadays? Medscape lists the adverse effects of one brand as irritability, nervousness, and palpitations and less frequently anorexia, constipation, gastrointestinal irritation, headaches, "hypersecretory conditions" (don't know and ain't asking), vertigo, and vomiting. To be fair, a University of Arkansas investigation of a claimed esophagus injury due to cider vinegar pills not only found "considerable variability" in the pills' acidity but expressed doubt "as to whether apple cider vinegar was in fact an ingredient in the evaluated products."

Many health claims for vinegar, e.g., that it will cure cancer or extend your life, are dubious to say the least, but a few may be legitimate. For example, research suggests that two tablespoons of vinegar taken in pretty much any form before a meal may help type-2 diabetics and those developing the disease control after-dinner spikes in blood sugar. More generally, a Swedish study found that vinegar was successful in increasing the "satiety rating" of foods, making them seem more filling and thus potentially helping with weight loss. Dunno if you're evidence for or against that proposition, Bernie, but who knows? Maybe you're on the cutting edge.

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