Apple cider vinegar supplements and beverages including Plix Apple Cider Vinegar are trendy in the wellness community due to their perceived advantages (weight loss, digestion, detox, etc.). Nonetheless, similarly to most of the natural remedies, they do not lack risks. To be able to use Plix apple cider vinegar safely and make informed choices, it is necessary to know the side effects.

In this paper we will examine the scientifically reported side effects of apple cider vinegar, and determine whether any side effects exist specific to the Plix formulations. We also offer safer consumption best practices.

What Is Plix Apple Cider Vinegar?

Some background: Before getting down to the risks, some context:

• Plix is a product which sells apple cider vinegar (frequently as effervescent or supplemental) with assertions of increased convenience and absorption.

• This active ingredient is still acetic acid, with trace minerals, vitamins and mother (in unfiltered forms).

• Since it has the same basic chemistry as standard ACV, several of the side effects are comparable to those of apple cider vinegar.

Therefore, the bulk of the information we have on ACV side effects apply to Plix, although with modifications based on formulation, dosage, purity and individual sensitivity.

Side Effects of Apple Cider Vinegar (and Plix) that are common

Side effects commonly reported and researched when taking apple cider vinegar in more concentrated supplement or drink form such as Plix, include:

1. Abdominal irritation / stomach ache.

• Nausea, bloating, stomach pain, indigestion, or heartburn–particularly on non-chewable or on increased doses.

• Slow gastric emptying: ACV can slow the rate at which food moves out of the stomach, and this can worsen the symptoms in those with gastroparesis.

• Diarrhoea or gastrointestinal discomfort in predisposed persons.

• Tooth enamel erosion / dental damage.

• The acid (acetic acid) may also dissolve away tooth enamel, making the enamel sensitive or resulting in tooth decay.

• Case reports: daily intake of undiluted vinegar has been associated with demineralization of the teeth.

• Throat / esophageal irritation or burns.

• Pure ACV, or tablets which become trapped in the throat can lead to throat irritation or even tablets burning the esophagus.

• A few case reports indicate that high-concentration vinegar products cause throat injuries.

• Hypokalemia (low potassium) and potential loss of bone.

• Intensive or extended use of ACV has been linked with a decreased level of potassium in the bloodstream that may cause muscle cramps, weakness or arrhythmia.

• In uncommon instances, chronic use has also been associated (through case reports) with bone mineral loss or osteoporosis.

• Change in blood sugar / glycemic activity

• ACV may reduce the level of blood sugar. Although this could be good in certain situations, the combination of this with antidiabetic drugs can result in hypoglycemia.

• Since the ACV decreases the rate of digestion, it may alter the level of blood sugar in diabetics, particularly Type 1, or when timely insulin administration is vital.

• Drug interactions

• Digoxin: There is an additional possible decrease in potassium by ACV, increasing the risk of digoxin toxicity.

• Diuretics (water pills): There are a lot of diuretics, which result in the loss of potassium; ACV can exacerbate these effects.

• Insulin / anti-diabetic drugs: There is a risk of additive effects on the glucose-lowering effect of ACV resulting in dangerously low blood sugar.

• Laxatives: When used in combination, there is a possibility that electrolyte disturbances are worsened.

• Blood pressure drugs / ACE inhibitors / ARBs: Due to the effects of potassium and fluid balances, there is the possibility of interaction.

• Irritation of the skin / chemical burns (topical application)

• Coming into direct contact with concentrated ACV (or undiluted Plix) can burn, blister or irritate skin–particularly in sensitive locations.

• There have been reported cases of skin damage when people applied ACV on skin wounds or moles or a topical agent.

• Potential impact on the functioning of the kidneys / acid-base balance

• Excessive acid load by ACV may further impair metabolic stress in the case of people with chronic kidney disease or acid-base mal-regulation.

• It has been reported that caution should be taken in individuals who have low renal capacity.

• Sensitivity / allergic reactions

• In some isolated cases, some people can be allergic to ACV or ingredients in a specific formulation (rash, itching, swelling).

• Individuals who are allergic to apples or yeast can be slightly more at risk.

1. Other possible minor impacts

• Burping, bloating and flatulence in a few users.

• Change of taste or aversive response to unpleasant flavor- result in aversion or nausea.

• Poor or inconsistent product quality: There can be variations in acidity or purity of some formulations, and thus the effects can never be predicted.

Are There any Side Effects of Plix?

Although most side effects are a result of the natural acidity of ACV and pharmacologic profile, there are other factors specific to Plix (or other branded preparations) which are:

Differences in concentration / formulation

• Plix can be taken as effervescent tablets, powders or more concentrated formulations that pose some risk when overdosed or as undiluted forms.

• Plexus Plix has unknown excipients or additives, which can cause sensitization or increase the risk of irritation.

Labeling / dosage confusion

• The user can misunderstand the strength or serving guidelines and end up taking in excess of that.

• The partial disclosure of acidity or safe limits may result in its abuse and increase in side effects.

Claims of marketing which result in overuse

• Brands can encourage aggressive regimens or high-dose which is likely to give users a temptation to consume them beyond safe levels increasing risks.

• Since the evidence-base does not support a lot of benefits, the process of overconsumption influenced by marketing can lead to very dangerous regions.

Tablet lodging risk

• Effusive or compressed pills can become trapped in the esophagus before dissolving thus leading to localized irritation or burns. This is a recorded danger of tablets of vinegar in general.

Batch-to-batch variability

• Commercial supplements are occasionally affected by acidic variation or contamination; batches of them vary, making it less predictable when such effects will occur.

Therefore, whereas Plix neither directly involves new risks that are not inherent to the typical ACV, its delivery mode, potency and advertising can enhance the side effects that are already present.

Risk Factors: Who ought to be particularly careful with Plix Apple Cider Vinegar?

Plix Apple Cider Vinegar will not have an adverse effect on all individuals that ingest it. Nonetheless, there are some categories of individuals who are susceptible to the possible danger of apple cider vinegar because of certain underlying health conditions, drug interactions, or individual sensitivities.

It is necessary to understand these risk factors to use them safely and responsibly.

Critical Patients Who must be Particularly careful:

1. Individuals that have gastric ulcer, GERD, and esophagitis

• The acidity of apple cider vinegar may aggravate irritation, burning and mucosal damage.

• ACV is not to be used or taken without medical guidance by those individuals with acid reflux or ulcers.

• Delayed emptying of the stomach (gastroparesis)

• ACV may bring about slowness in the emptying of the stomach, leading to bloating, nausea or stomach ache.

• Individuals with it should reduce the consumption or even avoid ACV unless prescribed by a medical practitioner.

• Those who are on insulin medication or diabetes medication

• Plix ACV can reduce blood sugar, which means they are more likely to have hypoglycemia when used with diabetes medication.

• Individuals with diabetes are supposed to check the level of sugar in their blood and seek the advice of a physician before they can use it regularly.

• Individuals who take diuretics, ACE inhibitors, ARBs, digoxin or laxatives

• These drugs influence the body fluid and electrolyte balance.

• Apple cider vinegar is capable of lowering potassium and therefore when used together with these medications, the body may experience electrolyte imbalances.

• Its use is not advisable to mix or frequently check lab findings.

• Individuals having low potassium levels (hypokalemia)

• ACV can also reduce the quantity of potassium thus causing muscle cramps, weakness, or irregular heartbeat.

• Persons at risk of hypokalemia must not take large amounts of Plix ACV or they ought to consult a doctor.

• People who have kidney disease or have renal dysfunction

• The acidic vinegar has the potential of exerting additional pressure on the kidneys and affecting the acid-base balance.

• Individuals who have problems with their kidneys are advised not to take large doses of ACV or use it consistently, without visiting a nephrologist.

• Individuals who are sensitive in their teeth or have weak enamel

• Plix Apple Cider Vinegar has an acid that has the potential to erode tooth enamel making it sensitive and decayed.

• You should always dilute ACV in water and then use a straw and even rinse your mouth with water to limit the harm.

• Lactating or pregnant women

• Limited study has been conducted on the safety of high dose ACV in pregnancy or lactation.

• Small serving portions in the culinary form are better with a limit and not concentrated supplements unless prescribed by a physician.

• Children

• Children are more sensitive to acidic chemicals which may result in burns or even irritation of the throat or ingestion injuries.

• Plix ACV supplements should not be given to children and where needed should be taken only in the form of a dilution in food.

1. Individuals who are allergic to apples or yeast.

• Individuals allergic to apples, yeast or fermented products can develop rashes, itching or swelling.

• In case of any allergic reaction, you should immediately stop and seek medical attention.

Practical Advice: Minimal Risk in the safe use of Plix or ACV

In order to reap the possible benefits and reduce the side effects, consider the following evidence-based best practices:

1. Start slow and low

Administration 1) Start with a small diluted preparation (e.g. 1/2 teaspoon in a glass of water) and see how it reacts.

• Stay within safe limits

The majority of guidelines indicate that not more than 1- 2 tablespoons (15- 30 mL) of ACV should be used in its diluted form per day.

In the case of supplements (such as Plix), instructions, as provided by the manufacturer, must be followed carefully and never used in excess.

• Always dilute

Do not consume ACV or Plix in full strength. Thoroughly use water to make the throat and teeth less acidic.

• Use a straw and rinse mouth

Consumption using a straw decreases the exposure to tooth enamel. Then, wash off (wait about 30 minutes and then brush).

• Take with food or meal time

Eating with meals aids in buffering acid and in alleviating the digestive discomfort.

• Space from medications

Administer ACV or Plix no less than 2 hours before drugs, particularly those that may interact with each other through potassium or blood sugar.

Observation of labs in case of interacting drugs.

When taking diabetes, heart or diuretics drugs, have electrolytes (particularly potassium) and kidney function checked regularly.

Do not use it before going to bed (some people).

ACV should not be taken immediately before sleeping.

• Be cautious with topical use

Never apply to broken skin, dangerous if used on the skin, always dilute, patch test it, and discontinue use in case of irritation.

Contact a doctor in case of symptoms.

Discontinue and get medical advice when you develop a sore throat, a new form of digestion problem, muscle cramps, irregular heartbeat and dental discomfort.

Summary & Take-Home Message

The side effects of Plix apple cider vinegar are more or less the same as the side effects of regular ACV- mostly caused by acetic acid and dosage.

Although a small dose of this type of drug may be safe to some, some of its effects such as eroding of the teeth, damage to the throat, potassium deficiency, stomachache and drug interactions are well known.

Individuals that have preexisting medical conditions (diabetes, kidney disease, acid reflux, low potassium, etc.) must take additional caution or steer clear of high-dose forms.

Never undilute, maintain safe doses, watch the side effects and always consult medical professionals, particularly when taking Plix or ACV with other drugs.