Apple Cider Vinegar: Benefits, Side Effects, Uses, Dosage, and More

Medically Reviewed
apple cider vinegar
Apple cider vinegar is useful as a cleaning agent, as a means to add extra flavor to dishes, and potentially as a way to help with certain diseases.Nadine Greeff/Stocksy

You may have a friend who insists on taking apple cider vinegar shots in the morning for fat burning. Or you may have seen apple cider vinegar drinks in the refrigerated section at the grocery store. With the exploding popularity of this seemingly basic pantry staple, you’re probably wondering what the buzz is all about.

What Is Apple Cider Vinegar Exactly?

First, let’s explore exactly what apple cider vinegar, or ACV, is. ACV is a type of vinegar made from fermented apple juice.

Like other cider- and wine-based vinegars, it has between 5 and 6 percent acidity.

You may notice that there are different types of ACV available at the store. For instance, you may be most familiar with distilled ACV, which looks clear in the bottle. But raw, unfiltered or unpasteurized ACV contains a cloudy substance that floats around in the mix. This is called the “mother,” and it’s formed by natural enzymes during fermentation. No need to be wary of it: This stringy substance usually settles to the bottom of the bottle, and it’s completely safe to consume.

Regardless of the variety, you do not have to refrigerate ACV, and it will last for a very long time. Vinegar, in general, has an almost indefinite shelf life. Even if vinegar's appearance changes (it may look cloudier, for instance), it’s still okay to use.

As for nutrition facts, diluted apple cider vinegar contains an insignificant amount of calories per serving; almost no fat, carbohydrates, or protein; and no fiber. Think of it as a great way to add a burst of flavor to foods without adding calories or extra salt.

ACV isn’t just available in liquid form; you can also buy ACV tablets, capsules, and gummies. Keep in mind, though, that ACV supplements may not be as potent as liquid ACV and will likely be more expensive.

What Are the Possible Health Benefits of Apple Cider Vinegar?

ACV has garnered superfood status, and fans of the vinegar say that it can cure nearly everything that ails you — weight gain, digestive issues, skin woes, and so on. Meanwhile, some companies tout ACV pills as a powerful source of vitamins and minerals, or for weight loss or “cleansing” support.

Few studies support these uses, so while you can add it to your diet without significantly upping your risk for weight gain, it’s best to stay realistic about it. ACV’s main health benefits may be due to the amount of antioxidant polyphenols (or plant chemicals) it contains, thanks to the fermentation process. It’s also rich in probiotics, which may benefit the digestive system and gut microbiome.

ACV and Weight Loss

ACV contains very few calories, so it can fit into your diet if you’re trying to lose or maintain weight. But you may also have heard that some people take a shot or tablespoon of apple cider vinegar to stimulate fat burning. The fact of the matter is that taking ACV is unlikely to change your body composition or weight.

Registered dietitian Katherine Zeratsky points out that this thought doesn’t have scientific support behind it — and the only way to actually lose weight is through a generally healthy diet and by incorporating fitness into your routine.

The advice is far less flashy than supplementing with something as trendy as ACV, but it’s exactly what really works.

ACV and High Cholesterol

ACV may be beneficial for high cholesterol in some groups.

For example, a June 2021 meta-analysis of nine studies noted that ACV might reduce blood cholesterol levels in participants with type 2 diabetes who took 15 milliliters (ml) of ACV daily for more than eight weeks. Researchers noted, though, that further study is needed to confirm this effect.

ACV and Type 2 Diabetes

Some research suggests that ACV may have benefits for people with type 2 diabetes, though there’s a lack of high-quality research on the topic.

The June 2021 meta-analysis found that 15 ml of ACV, taken daily over a period of at least eight weeks, significantly lowered fasting blood glucose levels in participants with type 2 diabetes.

But research isn’t consistent across the board. An earlier small study found that 20 ml of ACV didn’t decrease the body’s glucose response following a carb-rich meal.

While some studies have suggested that ACV may help lower blood glucose, it’s important to remember that results can vary, and ACV is not a replacement for any medication you currently take. If you have type 2 diabetes, you should work closely with your healthcare team on the best way to control the condition, rather than relying on ACV.

ACV and Ulcerative Colitis

Taking diluted vinegar may help improve digestion, though there’s a lack of research supporting its use in chronic autoimmune conditions like ulcerative colitis (UC). Giving UC mice diluted apple cider vinegar for a month lowered levels of inflammation in their colon and increased the amount of healthy bacteria in their gut, per a preliminary study. However, this was a single animal study, and researchers are far off from recommending it as a treatment.

ACV and Inflammation

Some people suggest taking apple cider vinegar as a treatment to manage symptoms in inflammatory conditions such as rheumatoid arthritis (RA), multiple sclerosis (MS), and ankylosing spondylitis (AS). One explanation is that the vinegar may reduce inflammation and lessen symptoms. However, there are no studies that directly explore ACV as a therapy for RA, MS, or AS. Talk to your doctor if you have one of these conditions before trying ACV.

ACV and Skin Conditions

There may be limited benefits for the use of topical ACV on a variety of skin conditions. But experts caution against applying undiluted vinegar directly to skin, noting that this practice can cause chemical burns.

Even diluted ACV can irritate the skin.

Eczema While there is little to no scientific evidence that ACV may be helpful with eczema, it’s possible that applying ACV to skin can help restore the skin’s natural pH barrier, thanks to ACV’s natural acidity.

 But a recent study found that soaking eczema-affected skin in diluted ACV did not affect skin barrier integrity compared with a control group — and it actually caused mild skin irritation in most participants.

 Talk to your dermatologist before using ACV topically.
Psoriasis If you have scalp psoriasis, applying organic ACV to the area can help lessen the itch from scaly patches, a common symptom associated with the autoimmune condition. There are some considerations to make before using it: Use diluted vinegar to decrease the risk of burning, and don’t apply to any area of the skin that’s cracked or bleeding.

Learn More About Possible Apple Cider Vinegar Benefits

What Are the Side Effects of Apple Cider Vinegar?

ACV is generally safe when consumed in moderation — no more than 1 to 2 tablespoons (tbsp) daily. But drinking excessive amounts of ACV can decrease potassium to hazardous levels.

ACV may interact with some medications (including diuretics, laxatives, and certain medications for diabetes and heart disease). If you take any of these medications, talk to your doctor if you’re considering taking ACV.

Other potential risks and side effects include:

  • Tooth enamel erosion
  • Esophageal burns
  • Gastrointestinal distress and acid reflux
  • Worsened chronic kidney disease
The U.S. Food and Drug Administration doesn’t approve dietary supplements, including ACV supplements, for safety or effectiveness. If you’re taking ACV supplements, follow the dosage directions on the packaging.

Always have a discussion with your doctor about anything you take, even if it seems as innocent or natural as vinegar.

ACV and Yeast Infections

Anecdotally, some have claimed that ACV may have some surprising properties for women’s health. But this has not been proven safe or effective, and experts caution against putting anything in your vagina, as it can disrupt its natural pH balance. Vinegar can also cause burning and irritation when applied topically, and vinegar douches can increase your risk of infections.

Do not try this on your own without consulting your gynecologist first.

Common Questions & Answers

Can I drink apple cider vinegar every day without side effects?
Maybe, as long as you stick to no more than 2 tbsp at a time. A safe approach involves ingesting diluted apple cider vinegar, such as in salad dressing, because the acidity of full-strength vinegar could cause side effects, including tooth enamel erosion. People with diabetes should be especially careful because vinegar could affect insulin levels.
How do you drink apple cider vinegar for weight loss?
ACV is low in calories and can be used to add flavor to a variety of dishes. Although research does not support it as a means of weight loss, some people have 1 to 2 teaspoons of apple cider vinegar around mealtime. But you'll want to talk to your healthcare team before adding this vinegar to your diet, especially if you're on medication.
What are the health benefits of apple cider vinegar?
Apple cider vinegar may carry digestive benefits, help stabilize blood sugar for people with diabetes, and kill some bacteria in meals (thanks to its antibacterial and antimicrobial properties). But don’t expect it to be a cure-all — research has suggested only modest results.
Is apple cider vinegar bad for the kidneys? What about the liver?
Apple cider vinegar could be dangerous if you have chronic kidney disease because the kidneys may have trouble processing extra acid. It doesn’t seem to pose a threat to the liver, but it won't help this organ work better, either. The liver does a good job of detoxing the body on its own.
How much apple cider vinegar should a person take per day?
Generally, most experts say not to ingest more than 1 to 2 diluted tbsp daily. Ask your doctor which dosage is right for you.

When Using Apple Cider Vinegar for Disease Treatment Is Risky

ACV is not a cure-all, and there’s no research to back many of the claims made about its disease-fighting abilities.

For example, there’s no proof that apple cider vinegar will lower high blood pressure, or hypertension.

There is also the unfounded claim that ACV can support treatment for schizophrenia. While there is emerging understanding of the role that the gut microbiome plays in psychiatric conditions, it’s a far leap to assume that ACV can improve gut health in such a way that it could directly affect symptoms. Such claims may instead relate to research on ACV’s potential benefits for alleviating GI discomfort sometimes caused by medications used for schizophrenia.

Another internet rumor states that vinegar can help treat cancer. If you have cancer, seek out a doctor for care. To date, no studies have directly linked ACV to the successful treatment of any cancers.

Learn More About Apple Cider Vinegar Side Effects

How Much Do You Know About Apple Cider Vinegar?

Apple cider vinegar is a staple that many people swear by, using it for everything from losing weight to toning skin. Test your knowledge and find out how much you know about this so-called natural cure-all.

Apple Cider Vinegar Uses

One of the most common — and classic — uses of ACV is in food preparation. Distilled ACV is a natural fit for salads and marinades, as well as canning and pickling (thanks to its 5 percent acid content). Unfiltered ACV can be used in cooking, salads, and marinades, and 1 teaspoon can be mixed into drinks to give some kick. As for cooking, ACV’s tang can complement a variety of dishes, from coleslaw and casseroles to syrups and sorbets.

ACV also features in many beauty products, like shampoo and toner, and it’s generally a safe ingredient. The Environmental Working Group rates ACV as a low overall hazard when in beauty products and an A (or lowest concern) as a cleaning ingredient.

When it comes to cleaning your home, ACV is a real multitasker because of its antimicrobial properties. Dilute ACV with water at a 1:1 ratio and use it to degrease your kitchen or clean mildew in your bathroom. You can also use ACV to clean sticky scissors, remove sticker residue from surfaces, deodorize a coffee pot, unclog drains, polish certain metals, freshen clothes, and remove stains. (A word of caution if you’re mixing ACV with baking soda: This will neutralize the ingredients and lessen their antibacterial effect.)

Apple Cider Vinegar Dosage

There's no universally agreed upon dosage of apple cider vinegar, and suggestions of how much to take vary depending on whom you ask.

Harvard Health Publishing points out that most recommendations for drinking diluted apple cider vinegar are 1 to 2 teaspoons prior to or during meals.

The University of Washington, on the other hand, recommends that if you’re taking apple cider vinegar as a supplement (by the spoonful, as a shot), you ought to stick to a limit of 1 to 2 tbsp at a time.

As noted, the ingredient is also used in topical creams and can come in tablet form; check packaging for dosage information.

Regardless of the delivery method or amount, there's no guarantee that apple cider vinegar will result in health or weight loss benefits. Simply put, more research is needed.

A Final Word About Using Apple Cider Vinegar

You can use apple cider vinegar on more than just salads. The ingredient may help you control your blood sugar and can be part of a healthy diet. It’s also extremely useful around the house for a variety of cleaning purposes.

But don’t rely on it as a magic weight loss cure or a treatment for chronic health conditions just yet.

Editorial Sources and Fact-Checking

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