Overview

Apple cider vinegar is an acidic substance that is made by fermenting apples. It is commonly used for many different reasons, but its benefits are not well defined. When it is applied to the skin, it may cause burning or irritation. When taken by mouth, it may cause acid reflux or an upset stomach. Apple cider vinegar is available as a liquid, capsule, or gummy. Drinking pure apple cider vinegar may damage your teeth or throat, so it is important to dilute it before use. Before using apple cider vinegar, make sure to tell your health care provider about any health conditions you have or medicines you are using.

Uses

What is apple cider vinegar used for?

Apple cider vinegar is used for many different reasons, although its benefits are not well defined. Some common reasons that people use apple cider vinegar include the following.

• To help manage diabetes
• To control high blood pressure
• For weight loss
• To increase athletic performance
• To treat or prevent infections

Note: The FDA has not reviewed apple cider vinegar for safety and effectiveness. Learn more about dietary supplements here.

How does apple cider vinegar work (mechanism of action)?

Apple cider vinegar is made by fermenting apples with bacteria or yeast. Although fruit vinegars are made mostly of water, they are naturally acidic and contain many different forms of acid. Apple cider vinegar typically contains acetic acid and citric acid. It also contains small amounts of some minerals and vitamins. The actual amount of acid in each apple cider vinegar product can vary widely depending on the way the vinegar was made. Apple cider vinegar is available as a liquid or in dietary supplements, such as capsules or gummies.

Pure acetic acid can kill the microbes that cause infections, such as bacteria, fungi, and viruses. This has led to interest in using apple cider vinegar to treat or prevent infections of the skin, mouth, or throat. But the acid must be present in a high concentration to do this. Each apple cider vinegar product contains a different amount of acetic acid — some products have a low concentration, while some have a high concentration. Even products with a high concentration may not have enough acetic acid to kill microbes. As a result, apple cider vinegar is not a reliable way to treat or prevent infections.

Some of the nutrients in apple cider vinegar may act as antioxidants and help reduce swelling (inflammation). There is also some speculation that vinegar can help reduce appetite, fueling interest in its use for a wide range of purposes. Some studies have found that taking apple cider vinegar may lower blood sugar levels after a meal. It may also help with weight loss by a small amount. But these changes are not likely to be meaningful for most people who have diabetes or who are trying to lose weight. Also, there is not enough research to know if apple cider vinegar is helpful for other uses.

Herbal products such as apple cider vinegar naturally contain many different chemicals. The amounts of each chemical in a specific apple cider vinegar product may vary. Different amounts may change the effects of apple cider vinegar on the body. Some apple cider vinegar dietary supplements are made to contain a certain amount of acetic acid. There are also some dietary supplements made from apple cider vinegar that only contain acetic acid.

How should I store apple cider vinegar?

You should store apple cider vinegar according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of apple cider vinegar?

The most common side effects of apple cider vinegar are listed below. These side effects may vary depending on the dose you are taking, the way you are using it, or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.

• Acid reflux or upset stomach (when taken by mouth)
• Burning or irritation (when applied to the skin)

There may be other side effects of apple cider vinegar that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of apple cider vinegar?

While less common, the most serious side effects of apple cider vinegar are described below, along with what to do if they happen.

Severe Allergic Reactions. Apple cider vinegar may cause allergic reactions, which can be serious. Stop using apple cider vinegar and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives, which can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Precautions

Who should not use apple cider vinegar?

Allergies to Ingredients. People who are allergic to any of the following should not use apple cider vinegar.

• Acetic acid
• Apple cider vinegar (ACV)
• Apple vinegar
• Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific apple cider vinegar products they stock.

What should I know about apple cider vinegar before using it?

Apple cider vinegar is a dietary supplement. It cannot be marketed to treat or cure a disease.

Read and follow the directions on the specific product you are using, or use it as recommended by your health care provider.

Keep apple cider vinegar out of the reach of children.

If you are taking apple cider vinegar as a gummy, chew the gummy well before swallowing. If you are taking liquid apple cider vinegar, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong amount. Ask your pharmacist which measuring device to use.

Apple cider vinegar is acidic. Drinking pure apple cider vinegar on a regular basis can damage your teeth or throat. If you are drinking liquid apple cider vinegar, it may be best to dilute it in water or use it for flavor on foods such as salads. This will help protect your teeth and throat from the acid in the vinegar.

If you are applying apple cider vinegar to your skin, it is important to dilute the vinegar before use. Pure apple cider vinegar can cause burns and irritation. Do not apply apple cider vinegar to open cuts or wounds, even if it has been diluted first. This could irritate or damage the wound.

Herbal products, such as apple cider vinegar, naturally contain many different chemicals. The amount of each chemical in a specific apple cider vinegar product can change for many reasons, including the type of apple that was used, the weather during the apple’s growth, and the methods used to make the vinegar. If you switch to a new bottle or a different brand, you may not have the same effects or side effects because of this variability. Talk to your health care provider if you have questions or concerns.

The FDA has not tested apple cider vinegar products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.

What should I tell my health care provider before using apple cider vinegar?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if apple cider vinegar is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions.Tell your health care provider if you have any of the following.

• Kidney problems
• Liver problems

Pregnancy. It is not known if or how apple cider vinegar could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if apple cider vinegar passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does apple cider vinegar interact with foods or drinks?

There are no known interactions between apple cider vinegar and foods or drinks.

It is unknown if drinking alcohol will affect apple cider vinegar.

Does apple cider vinegar interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

The interactions between apple cider vinegar and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with apple cider vinegar is incomplete. Always check with your health care provider before using apple cider vinegar with any medicines.

Dosing

What should I do if I accidentally use too much apple cider vinegar?

If you or someone else has used too much apple cider vinegar, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Apple cider vinegar comes in a range of doses and forms. Read the product label closely and speak with a health care provider about how to use apple cider vinegar safely. Do not use double or extra doses, even if you miss a dose.