apple cider vinegar

Apple cider vinegar (ACV) is a vinegar produced by fermenting the juice of apples. Its main active component is acetic acid, and it contains small amounts of vitamins and minerals. Beyond the familiar liquid, it is marketed as a dietary supplement in capsule, tablet, gummy, and powder forms.

According to Operation Supplement Safety (OPSS), a US Department of Defense program, "very little scientific evidence supports the safety and effectiveness of apple cider vinegar, especially as a dietary supplement." Some small studies of ACV consumed as a food have explored possible effects on blood sugar, insulin, cholesterol, or body weight, but OPSS characterizes this research as low quality and concludes that, so far, no research supports a proven health benefit from ACV taken either as a food or as a dietary supplement. The marketed uses above should therefore be treated as unproven.

There is no established or standardized dose. OPSS notes that ACV supplement labels do not consistently report ingredient amounts and that recommended dosages vary from product to product. Testing has also found some supplements with acid concentrations several times higher than ordinary household vinegar (which is generally about 4-7% acidity). Because any benefit is unproven and concentrated products may pose risks, talk to a clinician or pharmacist before taking apple cider vinegar supplements, particularly if you have a health condition or take any medication.

Supplement labels do not always reflect what is actually inside, and testing has found some products with acetic acid concentrations as high as roughly ten times that of household vinegar. The US Consumer Product Safety Commission treats acetic acid in concentrations greater than 20% as potentially poisonous. Concentrated or undiluted vinegar can be harmful, so caution is warranted, especially with high-strength supplement forms.

Per OPSS, reported side effects can include low blood potassium, skin irritation, chemical burns, and possible erosion of tooth enamel. Diluting liquid vinegar and avoiding contact with skin or ingestion of undiluted product may reduce some of these risks.

The cited source does not list any specific drug interactions for apple cider vinegar. As a general precaution from this site rather than a documented interaction: because ACV has been linked to low potassium, it may be prudent to be cautious if you take medicines or have conditions that can also lower potassium (for example certain diuretics or insulin). Discuss any supplement use with your clinician or pharmacist before combining it with prescription medications.