Apple Cider Vinegar: Health Benefits, Dosage, & Side Effects

Many claim that ACV offers important benefits, but what does science say?

Medically reviewed by Merlin Annie Raj, RD (Registered Dietitian) Merlin Annie Raj Merlin Annie RajRD (Registered Dietitian) facebook_iconlinkedin_icon
Written by , BSc, Professional Certificate in Food, Nutrition and Health Ravi Teja Tadimalla BSc, Professional Certificate in Food, Nutrition and Health linkedin_icon Experience: 8 years
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The benefits of apple cider vinegar make it worth adding to your diet. Traditionally, apple cider vinegar (ACV) is mainly used for digestive issues, skin problems, warts, dandruff, lice, and sore throats. ACV can also be used as a dietary supplement to promote weight loss, lower blood pressure, and manage sugar and cholesterol levels.

The health benefits of ACV may be attributed to its acetic acid, phenols, and probiotic bacteria. This article discusses the benefits of ACV, recommended dosage, and any potential side effects. Take a look.

What Is Apple Cider Vinegar?

Apple cider vinegar (ACV) is made by fermenting apple juice (Malus domestica). The fermented juice (or cider) contains ethyl alcohol that is converted to acetic acid by a microbe called Acetobacter (1).

The unpasteurized or organic ACV contains microbes. These microbes, such as yeast and bacteria, are also collectively known as the  “mother” and are rich in enzymes and proteins. They give ACV its characteristic cloudy appearance and provide probiotic benefits to the body.

ACV also contains minerals, vitamins, polyphenols, and lactic, citric, malic, and acetic acids (2).  A study reported that gallic acid and chlorogenic acid were dominant phenolic compounds in mother of apple vinegar (3). Acetic acid (5%) is the active compound of ACV. It is also responsible for the characteristic strong smell and sour taste. It may be responsible for the many purported health benefits (1).

Anecdotal evidence suggests many claims of ACV. Let us explore the scientific research behind it.

What Are The Benefits Of Apple Cider Vinegar?

1. May Have Antimicrobial Properties

Traditionally, ACV was used as a food preservative and disinfectant (4). It could help in preventing food spoilage as it prevents the growth of bacteria, such as Escherichia coli (1), (5).

A study reported that ACV showed antifungal properties against the Candida fungus (6). Another case report used ACV for treating vaginal candidiasis in a woman (7). Apple cider vinegar does have antimicrobial properties. However, more studies are needed to understand its therapeutic applications.

2. May Improve Digestion

The “mother” in the ACV is a probiotic. Probiotics help in improving the gut microbial population (8). There is scientific evidence that consuming fermented foods can help in keeping the gut healthy (9). These good bacteria help provide nutrients to the body and also prevent the growth of pathogens. Probiotic bacteria lower inflammation, boost immunity, and may also improve mental health (10), (11).

ACV contains acetic acid. Animal studies have reported that acetic acid has the potential to be used as a treatment for ulcerative colitis (12).

There is insufficient information to determine if ACV helps in treating acid reflux. A study highlighted a gap between anecdotal claims and empirical evidence regarding the use of ACV for treating esophageal symptoms (13).

3. May Promote Weight loss

The anti-inflammatory and anti-adiposity properties of ACV may prevent obesity and obesity-related cardiac complications induced by a high-fat diet. This was found in rat studies (14). Another study on rats fed with a high-fat diet reported that ACV may reduce the risk of obesity due to its antioxidant activity (15).

Results from animal studies have concluded that ACV has significant anti-hyperlipidemic activity in rats with hyperlipidemia (high cholesterol) (16). Weight loss was observed in rats treated with ACV. Their lipid parameters were also consistent (16).

In other studies, test subjects who consumed ACV for eight weeks had lower levels of unhealthy fats or lipids (17).

Vinegar has also been effective against obesity, according to a Japanese study (18). The results of the study indicated that vinegar intake reduced body weight (weight loss), body fat mass, visceral fat and serum triglyceride levels in obese Japanese subjects (18).

In another study, vinegar also increased satiety after a bread meal in healthy subjects. This may help in combating obesity (19). Another study states that using vinegar may help reduce postprandial glycemia (20).

However, the scientific community is divided over the effectiveness of ACV helping in weight loss. Hence, we need more studies in this regard.

4. May Improve Heart Health

Animal studies have revealed that vinegar can reduce blood triglycerides and cholesterol (21). Dietary acetic acid reduced serum total cholesterol and triacylglycerol in rats fed with high cholesterol diets (21),(22), (23).

A study analyzed the effect of vinegar on hypercholesterolemic rabbits (22). Vinegar lowered most of the biochemical parameters, like cholesterol, C-reactive protein (CRP), and apolipoprotein A (ApoA), that may increase the risk of cardiovascular disorders, like atherosclerosis (22).

Hypertension or high blood pressure may lead to heart problems. Vinegar was also found to reduce blood pressure in rats (24), (25). These preliminary studies on animals need to be confirmed in humans.

5. May Help Manage Diabetes

Studies on diabetic mice have revealed that ACV can lower blood glucose levels (26). In healthy subjects, ACV could lower blood sugar levels and insulin response after a meal (20). However, in subjects with diabetes, it does not delay gastric emptying (27).

Most studies claim that vinegar lowers blood glucose levels (28), (29), (30). However, other studies state that vinegar could be more effective in regulating blood sugar levels in healthy individuals than those with diabetes (31).

6. May Boost Skin Health

Apple cider vinegar contains alpha-hydroxy acids, including lactic and malic acids. These acids have been used extensively in skin care (32).

Lactic acid improves skin hydration (32), (33). It also gently exfoliates skin (sloughs off dead skin layers), improves skin texture, and helps reduce fine lines by boosting cell renewal (34), (35). Lactic acid is also reported to treat dark circles and hyperpigmentation when combined with trichloroacetic acid (36).

Studies reported that vinegar in a cream base improves atopic dermatitis in mice (37). Anecdotal evidence suggests that ACV may help relieve symptoms of psoriasis, including itching and scaly patches. However, there is no scientific data to back this claim.

ACV has antimicrobial activity. It may help in treating acne-prone skin. However, more research is warranted in this area.

The topical application of ACV may cause skin burns and skin irritation (38). Hence, practice caution.

7. May Improve Immunity

ACV is rich in antioxidants and phenols. These compounds help in scavenging toxins from cells produced during oxidative stress (39). Many folk remedies use ACV to treat inflammation related diseases, like multiple sclerosis, ankylosing spondylitis, and rheumatoid arthritis.

However, the scientific evidence in this aspect is scarce. On the contrary, a study claimed ACV to be ineffective as an anti-arthritic and anti-inflammatory agent in rats with adjuvant arthritis (40).

8. May Help Treat Polycystic Ovarian Syndrome (PCOS) Symptoms

A study investigated the effect of ACV with the mother (the beneficial yeast and bacteria) on reproductive hormones. ACV reduced the levels of estrogen and testosterone but increased progesterone levels in Wistar rats (41).

Research suggests that the intake of ACV can help with regulating ovulatory function in women with polycystic ovary syndrome (42). It was also reported that consuming 15 g of apple vinegar daily for 90 to 110 days helped improve insulin sensitivity and restored regular periods (42).

These are the potential benefits of apple cider vinegar. Some of them are yet to be confirmed in humans. In the following section, we will look at the dosage of ACV and the ways to use it.

Dosage And How To Use

Anecdotal remedies suggest ingesting 1 teaspoon to 2 tablespoons (10–30 ml) of ACV per day. It can be mixed with water and taken or can be added to salad dressings and marinades. Below, we have discussed ACV recipes targeted for specific health concerns (none of these have been backed by research; consult your doctor before trying any):

Digestion

What You Need

  • 15-30 mL ACV
  • 1 glass of water

Process

Mix the ACV in water and drink it before meals.

Weight Loss

What You Need

  • 15-30 mL ACV
  • A few drops of lemon juice
  • 1 glass of water

Process

Mix the ACV in water and drink it on an empty stomach early in the morning.

Polycystic Ovarian Syndrome (PCOS)

What You Need

15 mL ACV

Process

Drink one tablespoon of ACV everyday for around 3-6 months.

Hair Rinse

What You Need

  • 10 mL ACV
  • 1 tablespoon honey
  • A few drops of lemon juice
  • Water (as needed)

Process

Mix all the ingredients in water and use this as a hair rinse after shampooing. The vinegar smell would vanish gradually.

Skin Toner

What You Need

  • 10 mL apple cider vinegar
  • 10 mL rose water
  • 20 mL water

Process

  1. Mix all the ingredients in water. Dip a cotton ball in this mixture and dab it evenly on your skin. You can also spritz it on your face. Use diluted ACV as concentrated ACV can cause skin burns or irritation.
  2. Use a moisturizer after this step.

Mouth Wash

What You Need

  • 15 mL apple cider vinegar
  • 30 mL water

Process

Use diluted vinegar as a mouthwash. Swirl it around for 20-30 seconds and rinse with water afterwards. This will kill the bacteria in the mouth and keep bad breath at bay.

You can try using ACV in these ways and experience results. However, ACV may also cause side effects in some people.

Apple Cider Vinegar Side Effects

Apple cider vinegar is relatively safe to consume. However, its acidic nature may cause a mild burning sensation in the throat and stomach.

It may cause damage to the tooth enamel and cause dental erosion (43).

In a study, prolonged consumption of ACV had caused hypokalemia (potassium deficiency) in a woman (44).

The topical application of undiluted vinegar can lead to skin burns and irritation (38), (45).

ACV may also cause nausea, acid reflux, burping,  flatulence, and irregular bowel movements (46), (47).

Apple cider vinegar’s benefits are gaining popularity worldwide and rightly so. Rich in anti-oxidative phenols, acetic acid, and probiotics, apple cider vinegar not only helps improve your digestive, skin, and hair health but also aids in weight loss and managing your blood cholesterol levels. Apple cider vinegar also helps keep your blood sugar levels in check, helping you to manage diabetes better. It is also popularly used in detoxifying drinks to help you cleanse your body. While it is safe to consume 1-2 teaspoons of apple cider vinegar in drinks or dressings per day, over and prolonged consumption may lead to certain avoidable side effects.

Frequently Asked Questions

Can I drink apple cider vinegar every day?

There have been reports that prolonged intake of ACV may be harmful to the bones as it interferes with calcium absorption. Hence, do not take it every day.

When should you drink apple cider vinegar?

Generally, it is consumed before meals, but it can be taken anytime.

How does apple cider vinegar detox your body?

There is not enough data to support the claim that ACV detoxifies the body. However, it contains antioxidant and anti-inflammatory compounds that may help.

How much weight can you lose with apple cider vinegar in a week?

There are no studies available currently about the parameters involved.

What does apple cider vinegar do for your hair?

It has been suggested that it balances the pH of the scalp and helps remove dandruff.

Does ACV affect urine?

No studies have been done in this aspect.

How many times a day can you drink ACV?

ACV can cause adverse effects like nausea and acid reflux when consumed frequently or in excess. Hence, do not take it more than thrice a week or once a day.

What are the benefits of apple cider vinegar and honey?

Anecdotal remedies suggest that ACV with honey may help with weight loss and improve digestion.

How long does it take to detox with apple cider vinegar?

Home remedies suggest that ACV takes about a week to detox your body. However, there is no scientific proof to back this claim.

Which apple cider vinegar is best for weight loss?

ACV with the mother is suggested to be good for weight loss.

Is apple cider vinegar good for kidney stones?

There is very less research in this regard. Hence, it is important to consult a doctor.

Is it OK to drink apple cider vinegar on an empty stomach?uestion

Yes, you can. But practice caution as it may cause side effects like nausea.

Does apple cider vinegar give you energy?

ACV may help regulate blood sugar levels. This may offer energy.

How do you protect your teeth with apple cider vinegar?

You can have ACV in a diluted form. You can also use a straw to prevent the ACV from damaging the enamel of the teeth.

Does apple cider vinegar make you poop?

Folk remedies recommend ACV as a cure for constipation. However, it is known to cause diarrhea when consumed in excess. There is no concrete research to substantiate its claims.

References

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Merlin Annie Raj

Merlin Annie RajRegistered Dietitian Nutritionist

Merlin Annie Raj is a Registered Dietitian based out of Hyderabad, India. She has 14 years of experience in Clinical Nutrition as well as teaching Nutrition and Dietetics to undergraduate and postgraduate students. She was awarded the ‘President’s Award’ at the 47th Annual National Conference of the Indian Dietetic Association, 2014.   Merlin has conducted various weight management programs, prepared...read full bio