Apple Cider Vinegar Benefits vs. Side Effects to Know

Apple cider vinegar is a type of fermented juice made from crushed apples and yeast. Making apple cider vinegar leads to the formation of acetic acid. Acetic acid is thought to be the cause of many potential benefits of apple cider vinegar.

Apple cider vinegar is commonly used in cooking, but it has also traditionally been used for medicinal purposes. It is believed to have antioxidant, antiviral, and antimicrobial capabilities. Apple cider vinegar has also been studied for its role in lowering blood sugar, treating acne and other skin conditions, and improving heart health. However, only some of apple cider vinegar’s benefits are backed by science, while others remain unproven.

This article looks at the science-backed benefits of apple cider vinegar, its possible side effects, precautions, interactions, and dosage information.

Dietary supplements are not regulated the way drugs are in the United States, meaning the Food and Drug Administration (FDA) does not approve them for safety and effectiveness before products are marketed. When possible, choose a supplement tested by a trusted third party, such as USP, ConsumerLabs, or NSF. 

However, even if supplements are third-party tested, that doesn’t mean they are necessarily safe for all or effective in general. Therefore, it is important to talk to your healthcare provider about any supplements you plan to take and check in about potential interactions with other supplements or medications.

Supplement Facts

• Active ingredient(s): Acetic acid, polyphenolic compounds

• Alternate name(s): ACV, cider vinegar, apple vinegar
• Legal status: Legal and sold over the counter in the United States 
• Suggested dose: No universal dosage recommendations
• Safety considerations: Possible side effects include burning and stomach irritation; precautions should be taken

Purported Uses of Apple Cider Vinegar

Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease. 

Apple cider vinegar is produced when apple cider is fermented. During this process, bacteria and yeast interact with the sugar naturally found in apples. The final result is apple cider vinegar, which contains acetic acid, a component of all kinds of vinegar.

Apple cider vinegar may be consumed as a beverage, added to salad dressings and marinades, or used topically.

Apple cider vinegar is believed to support human health in various ways. Below is a look at what the research says about some of apple cider vinegar’s potential benefits.

Blood Sugar

The acetic acid in apple cider vinegar may help lower blood sugar.

A 2017 research review showed that taking vinegar along with meals lowered both sugar and insulin levels in the blood, two factors often elevated in people with type 2 diabetes. Researchers from the study concluded that vinegar, including apple cider vinegar, has the potential to be used alongside medications and lifestyle changes to manage blood sugar.

A more recent systematic review found that consuming apple cider vinegar decreased both fasting blood sugar and HbA1C, two parameters used to diagnose type 2 diabetes. The review looked at nine studies in which adults consumed varying amounts of apple cider vinegar. However, most of the studies did not control the participants’ dietary intake, which could affect overall outcomes. Additionally, the number of studies in the review was relatively low.

Acne and Other Skin Conditions

Some believe that apple cider vinegar can improve acne and other skin conditions, but these claims are mostly unfounded. As an example, a small study looking found topical apple cider vinegar provided no benefits for people with atopic dermatitis.

Regardless, some people continue to use topical apple cider vinegar for acne and other skin conditions, providing only anecdotal evidence that it works.

On a related note, there is some research suggesting that applying apple cider vinegar to varicose veins, or raised, sometimes painful blood vessels on the skin, may make them less noticeable. Researchers concluded that apple cider vinegar could be an acceptable complementary and alternative medicine (CAM) to improve the quality of life for patients with varicose veins.

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Antifungal Properties

One of the overarching claims of apple cider vinegar is that it contains antifungal properties, making it a potential treatment option for a wide range of health conditions.

However, despite a bevy of anecdotal evidence pointing to the antifungal properties of apple cider vinegar, scientific research supporting this claim remains lacking.

An in vitro (test tube) study concluded that apple cider vinegar contains antifungal properties. In the study, apple cider vinegar was found to be a possible therapeutic option for those with a fungus, candida, growing on their dentures. However, it should be noted that this study was performed in a test tube and should be replicated on humans to strengthen the results.

Other, similar lab studies reporting the positive effects of apple cider vinegar on various types of fungi do exist, but human trials are few and far between.

Antibacterial Properties

In some studies, apple cider vinegar has been found to contain various antibacterial properties. This means apple cider vinegar has the potential to be used to treat some types of bacteria, including E. coli and staph infections.

Once again, however, these results have mostly been found via lab studies.

In one such study, apple cider vinegar was proven to damage cell structures and prevent growth in E. coli and other bacteria. Researchers felt that these results meant that apple cider vinegar could be a useful treatment for various bacterial infections.

More human trials are needed to confirm apple cider vinegar’s antibacterial properties.

Heart Health

Emerging research has shown that apple cider vinegar could be useful in improving the health of your heart.

High levels of lipids and cholesterol in the blood are risk factors for heart disease. A systematic review from 2021 found that apple cider vinegar consumption was linked to decreased levels of total cholesterol in the blood. According to the study, apple cider vinegar may block the formation of new fat cells and help remove cholesterol from the body.

Large-scale human trials should be conducted to repeat and confirm these positive results.

What Are the Side Effects of Apple Cider Vinegar?

Apple cider vinegar may be a popular supplement, but, like most other supplements, using it comes with possible side effects. Side effects associated with apple cider vinegar may be mild or severe.

Common Side Effects

Side effects may be more likely if apple cider vinegar is not used properly. Therefore, be sure to follow directions for use closely.

In general, apple cider vinegar is thought to be safe. However, there have been reports of digestive issues, like digestive intolerance and stomach burning, from using it.

Apple cider vinegar may also cause tooth erosion. In one lab study, human teeth that were submerged in different types of vinegar for up to eight hours became eroded and lost minerals. These results are thought to be due to the acidic nature of vinegar, which is why it is not recommended to allow apple cider vinegar to come into contact with your teeth, hair, or skin for long periods.

Although few additional side effects have been reported, others may be possible when taking apple cider vinegar.

Severe Side Effects

Apple cider vinegar is highly acidic, which means it can cause issues for some people if not used properly.

For instance, in rare cases, apple cider vinegar has caused various types of burns when used improperly.

In an old report, some young children who consumed vinegar unsupervised experienced throat burns and, in some cases, scarring of the esophagus. For this reason, it is recommended that all types of vinegar be kept out of reach of children.

Similarly, improper use of apple cider vinegar caused a chemical burn in one teenage girl who repeatedly applied too much to an area of her skin with the hope of removing a mole.

Again, it should be noted that using apple cider vinegar as directed can help you reduce your risk of both common and severe side effects.

Precautions

Apple cider vinegar is considered safe when consumed in small amounts for a short period. However, apple cider vinegar may not be safe if consumed long term or in large doses.

Although you may have heard of the benefits of putting apple cider vinegar on your skin, doing so may not be safe either. Apple cider vinegar applied directly to the skin may cause chemical burns.

It is unknown if apple cider vinegar is safe to use during pregnancy or lactation. Therefore, people who are pregnant or breastfeeding should practice caution and avoid using apple cider vinegar.

Apple cider vinegar is believed to be safe for children, but parents should take precautions and only provide recommended doses. It is also best to keep apple cider vinegar out of the reach of small children to prevent accidental overconsumption.

People with low potassium should avoid using apple cider vinegar as it may lower potassium levels further. More research is needed to confirm these claims.

Dosage: How Much Apple Cider Vinegar Should I Take?

Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs. 

More research is needed to know how much apple cider vinegar you can safely consume. As such, there is no standard, recommended dose of apple cider vinegar.

In general, small doses of apple cider vinegar are usually well-tolerated, while large doses are more likely to cause side effects.

Scientists have used varying doses of apple cider vinegar in their research, yet many of these studies have not been performed on humans. In one systematic review of nine studies on apple cider vinegar, doses ranged from 15 milliliters per day to 770 milliliters per day.

To find the right dose for you, speak with your healthcare provider.

What Happens If I Take Too Much Apple Cider Vinegar?

There are no reported cases of apple cider vinegar overdose. And apple cider vinegar is also considered nontoxic.

However, taking too much apple cider vinegar may cause side effects, like stomach burning.

Typically, side effects associated with taking too much apple cider vinegar should disappear with time and once you stop using it. But talk with your healthcare provider about what to do if you take too much.

To prevent possible side effects, use apple cider vinegar only as directed.

Interactions

Many supplements interact with certain medications or other supplements, and apple cider vinegar is no exception.

Apple cider vinegar may interact with some medications, including:

• Insulin
• Water pills (diuretics)
• Antidiabetic drugs

• Digoxin

People taking these medications should be cautious when using apple cider vinegar. If determine if it is safe to take apple cider vinegar.

Additional drugs, supplements, or foods may interact with apple cider vinegar.

It is imperative that you carefully read the nutrition facts and ingredients list on the supplement label to know which ingredients and how much of each ingredient is included. Please review the supplement label with your healthcare provider to learn about any potential interactions with other supplements, foods, or medications. 

How to Store Apple Cider Vinegar

To increase the shelf-life of apple cider vinegar, it needs to be properly stored.

Store apple cider vinegar in a cool, dry place. You do not have to refrigerate it, but you can. Wherever you choose to keep your apple cider vinegar, make sure it stays out of both heat and direct sunlight.

Apple cider vinegar is said to have a very long shelf life, but it should be discarded once it reaches its expiration date or loses flavor.

Remember to keep apple cider vinegar out of the reach of small children who may accidentally consume too much.

Similar Supplements

Many different supplements are similar to apple cider vinegar and may be used to treat the same conditions. These similar supplements include:

• American

  ginseng

  : Ginseng is an herb that may be useful in increasing blood glucose in type 2 diabetes. A review of ginseng’s effect indicated that American Ginseng extract is a safe treatment that may help people with type 2 diabetes lower their blood sugar when used as a complementary supplement. However, supplements should never replace standard medical treatment.

• Vitamin A (retinol): While it has not been determined whether apple cider vinegar benefits acne, it is known that vitamin A, or retinol, supplements may be beneficial. A recent review found that people who took varying doses of oral vitamin A had improvements in their acne symptoms, enough so that researchers suggested it could be a viable alternative to certain acne medications.

• Wormwood: Wormwood is a plant that may also be a natural antimicrobial agent. It has been used in traditional medicine for its antimicrobial and antifungal properties, along with other perceived benefits.

• Coenzyme

  Q10: Coenzyme Q10 (CoQ10) is a substance found in the human body and in supplement form thought to benefit the health of your heart. Although research is still emerging, some studies suggest that CoQ10 could be useful in the treatment of

  dyslipidemia

  , oxidative stress, heart failure, and heart

  arrhythmias

  .

It’s typically recommended to avoid taking multiple supplements at the same time for a single condition. Therefore, talk to your healthcare provider about which supplement may be right for you.

Frequently Asked Questions

• Is it OK for everyone to use apple cider vinegar?

  While apple cider vinegar may be useful for some, it is not advised for certain people. For instance, people who are pregnant or breastfeeding, those taking certain medications, or those with low potassium levels in their blood may have a negative reaction to apple cider vinegar.

  If you’re unsure if apple cider vinegar is right for you, talk with your healthcare provider.

  Learn More:

  Should You Use Apple Cider Vinegar for Migraine Pain?

• Can apple cider vinegar help with acid reflux?

  Apple cider vinegar might help with acid reflux when other dietary supplements are used alongside it. However, evidence for using apple cider vinegar for acid reflux has been mostly anecdotal.

  Study participants from small studies have felt that apple cider vinegar helped reflux symptoms. Yet researchers are unsure if apple cider vinegar can truly be pinpointed as a beneficial substance.

  Learn More:

  Using Apple Cider Vinegar for GERD

• Is vinegar a strong acid?

  All kinds of vinegar, including apple cider vinegar, are considered very acidic.

  On the pH scale, apple cider vinegar is between levels two and three, with level one indicating the most acidic substances.

  Because of its acidity, using too much apple cider vinegar may lead to side effects like chemical burns and tooth erosion.

  Learn More:

  What is pH Balance?

Sources of Apple Cider Vinegar & What to Look For

Apple cider vinegar is found in both food (beverage) and supplement forms. The best form for you may be the one that is easiest to use.

Food Sources of Apple Cider Vinegar

Apple cider vinegar is not naturally found in foods. You can find apple cider vinegar in liquid form in supermarkets and online. You may choose to drink apple cider vinegar on its own or add it to various foods and recipes.

You can buy filtered or unfiltered apple cider vinegar. The main difference between the two is that unfiltered apple cider vinegar still contains a substance called the “mother.” While research is conflicting, the mother is believed to contain probiotics, which are good bacteria for your gut.

Apple Cider Vinegar Supplements

Apple cider vinegar is popular in its liquid form, but it can also be found as a supplement.

Apple cider vinegar supplements may be gummies, capsules, or tablets. Be sure to read the nutrition label, as some apple cider vinegar supplements contain additional vitamins, minerals, and other ingredients.

Unless told otherwise by your healthcare provider, follow the dosage directions listed on the supplement label. Never take more apple cider vinegar than instructed, as doing so can cause side effects.

And remember, the FDA considers dietary supplements as food, not as drugs. No supplement has been tested by the FDA for any health condition it may claim to treat. Some products may also contain hidden ingredients that are sometimes falsely marketed as dietary supplements.

For the best products, look for brands that have been reviewed and approved by independent agencies.

Summary

Apple cider vinegar is a popular product that has been used for many years. While there is some evidence of health benefits, not all of the perceived uses of apple cider vinegar are backed by science.

It’s important to be aware of the possible side effects associated with using apple cider vinegar.

If you’re considering using apple cider vinegar for any health purpose, speak with your healthcare provider to determine if it’s right for you.