Apple cider vinegar (ACV) is the fermented juice of crushed apples. The sour-tasting liquid is a popular ingredient in salad dressings, marinades, and sauces. ACV is also popular as a health supplement, as it contains beneficial compounds and nutrients like vitamins B and C.
ACV has many proposed health benefits, such as lowering blood sugar levels, supporting weight loss, and treating infections. However, there isn’t sufficient evidence to support these uses. Most evidence supporting the benefits of ACV is based on the liquid form, and there is very minimal research available about the benefits of ACV supplements.
Type 2 diabetes is a chronic (long-term) condition characterized by high blood glucose (sugar) levels. It occurs when your body can’t use insulin—a hormone made by the pancreas—properly. If left untreated, type 2 diabetes can lead to heart disease, kidney disease, vision problems, and nerve damage. Therefore, treatment aims to reduce your blood sugar levels and maintain them in a healthy range.
There is some evidence that ACV can reduce fasting and postprandial (after eating) blood sugar levels and hemoglobin A1C (HbA1C)—a test that measures your average blood glucose levels for the past two to three months.
- A review of nine studies found that ACV significantly lowered fasting glucose levels and HbA1C in participants with type 2 diabetes. It was shown to lower fasting blood sugar levels by almost 8 milligrams per deciliter (mg/dL) and HbA1C levels by 0.50%.
- A small clinical trial of 80 people found that daily consumption of ACV resulted in significant decreases in fasting blood glucose levels and HbA1C. Participants consumed 30 mL—or 2 tablespoons—of ACV per day for eight weeks.
- Another research review found that ACV lowered post-mealtime glucose and insulin levels.
While this evidence appears promising, these studies were focused on the liquid form of ACV rather than supplement forms. One study that compared liquid ACV to ACV tablets found that the tablets were not as effective as the liquid in reducing post-mealtime blood sugar levels. More research is needed to understand the potential benefits of ACV supplements on blood sugar levels.
Overweight and obesity are conditions in which your body has excess fat that can cause health problems. They can increase your risk of various health conditions, such as heart disease, high blood pressure, cancer, and stroke. Treatment options may include a combination of medication, lifestyle changes, and surgery.
Many people believe that ACV can help with weight loss and obesity. However, this claim isn’t well supported; only a few small studies have confirmed this benefit.
One small study of 39 participants tested the effects of ACV in people who were overweight or obese. Researchers found that participants who took 30 mL of ACV daily and followed a restricted calorie diet (RCD) for 12 weeks lost more weight and body fat than those who only had implemented an RCD. However, this study did not account for other weight-loss factors, such as exercise.
Another recent study investigated the effects of ACV on weight and other parameters in people who were overweight or obese. Participants who had ACV daily for four to 12 weeks had significant reductions in weight and body fat without considerable side effects.
Cholesterol is a fatty substance that helps make hormones, vitamins, and compounds that help with digestion. Your body makes all the cholesterol it needs. However, certain factors, such as smoking, stress, and a diet rich in saturated fat, can increase the amount of cholesterol your body makes.
High cholesterol levels increase your risk of serious health problems, including stroke, heart attack, and carotid artery disease. So, it’s important to keep your cholesterol levels in a healthy range.
ACV may help lower levels of certain types of cholesterol.
One research review found that ACV significantly decreased total cholesterol levels by about 6 mg/dL. However, there was no considerable effect on low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol, or high-density lipoprotein (HDL) cholesterol—the “good” cholesterol.
Traditionally, antibiotics are used to treat bacterial infections. However, antibiotic resistance—when bacteria change and become resistant to the effects of antibiotics—is a growing problem. Antibiotic resistance can cause infections that are difficult and sometimes impossible to treat.
Some people may consider alternative supplementation to fight off bacteria. However, it’s important to still seek medical care if you think you have a bacterial infection.
One study found ACV had antimicrobial activity against certain strains of bacteria, such as Escherichia coli and Staphylococcus aureus.
Another study found that ACV liquid and ACV tablets at a dose of 200 micrograms per milliliter (mcg/mL) were effective against methicillin-resistant Staphylococcus aureus (MRSA) and resistant Escherichia coli (rE.coli).
More research is needed before ACV can be recommended as a treatment for bacterial infections.
Apple cider vinegar is most commonly found as a liquid. It’s also sold in powder, tablet, capsule, and gummy form.
The best time of day to take ACV depends on the reason for usage. Some research suggests that taking it before or with meals can help reduce post-mealtime blood sugar levels. Other studies had participants take ACV before meals to better reduce appetite and increase satiety (feeling of fullness).
Dosage
There is limited research on apple cider vinegar supplements, and there isn’t a standard dosage. The amount of ACV in each supplement also varies depending on the product. Consult a healthcare provider to determine the proper dosage for your condition.
Daily intake of 15 mL of ACV liquid has been shown to have various health benefits. ACV liquid is commonly used in foods, such as salad dressings, sauces, and marinades. It may also be diluted with water or tea and consumed as a beverage. It’s important to dilute ACV, as undiluted ACV is highly acidic and can damage your teeth and esophagus.
ACV is usually safe when used in food. When used for medicinal purposes, it is possibly safe if used for a short time. However, consuming large amounts of ACV for a long time can cause side effects, including low potassium levels. Because of this risk, using ACV is not recommended if you have low potassium levels. ACV can also harm your teeth, esophagus, and skin.
Due to a lack of information, it’s not known whether ACV is safe to use medicinally if you’re pregnant or breastfeeding. If you’re pregnant or breastfeeding, it’s recommended to only consume ACV in food amounts.
Potential Drug Interactions
Because ACV can lower potassium and blood sugar levels, it can interact with several medications, herbs, and other supplements, including:
- Lanoxin (digoxin): Consuming large amounts of ACV can lower potassium levels. This can increase the risk of side effects from Lanoxin (digoxin).
- Insulins: Insulin drugs and large amounts of ACV can decrease potassium levels in your body. Therefore, combining these products can make this side effect more likely to occur.
- Diabetes medications: ACV may lower blood sugar levels. If you’re taking diabetes medications, your blood sugar may drop too low.
- Diuretics (water pills): Some diuretics can lower your potassium levels. Because large amounts of ACV can also lower potassium levels, taking these together can increase the risk of this side effect.
- Herbs and supplements that lower blood sugar levels: Certain herbs and supplements—such as aloe, bitter melon, cassia cinnamon, chromium, and prickly pear cactus—lower blood sugar levels. Therefore, taking them with ACV can drop your blood sugar too low.
- Herbs that contain cardiac glycosides (substances that strengthen the heart’s contractions): Several herbs, including black hellebore, foxglove, lily-of-the-valley, oleander, and pleurisy root, contain cardiac glycosides, which can lower potassium levels. Because ACV can also lower blood potassium levels, combining it with these herbs may increase the risk of side effects from very low potassium levels.
- Horsetail: Combining ACV and horsetail can increase your risk of low potassium levels.
- Licorice: Consuming ACV and licorice can cause your potassium levels to drop too much.
- Stimulant laxative herbs: Taking ACV with stimulant laxative herbs can increase the likelihood of low potassium levels.
Can You Take Too Much?
While ACV is usually safe in food, taking too much can cause side effects. This typically occurs when using ACV for medicinal purposes. Side effects may include:
- Low potassium levels
- Nausea
- Damage to the throat, tooth enamel, and skin
If you consume ACV in food or take it medicinally for a short time, side effects are unlikely. However, if you take ACV in large amounts for a long time, adverse effects can occur. These can include:
- Low potassium levels
- Erosion of tooth enamel
- Throat and skin burns
Apple cider vinegar comes from the fermented juice of crushed apples. It contains nutrients such as vitamins B and C and has many proposed health benefits, including reducing blood sugar levels, promoting weight loss, and treating infections. However, there isn’t enough reliable evidence to support these uses, and most of the research has been done on ACV liquid rather than supplements.
