Introduction

Apple cider vinegar (ACV) has gained popularity as a natural remedy with a variety of health claims. Made from the fermented juice of crushed apples, ACV contains beneficial compounds such as acetic acid, vitamins B and C, and other bioactive substances. While it's often used in cooking, ACV is also marketed in supplement form as a wellness aid.

But what does the science say? Here's a look at the potential health benefits, how to take ACV, and important safety considerations, based on current research and expert insights.

Key Benefits of Apple Cider Vinegar

1. May Help Lower Blood Sugar

Several small studies suggest ACV may assist in reducing blood sugar levels, especially in people with type 2 diabetes or insulin resistance. Research has shown:

  • ACV may lower fasting blood glucose and HbA1c (a long-term marker of blood sugar).

  • A review of nine studies found a reduction in fasting blood sugar by about 8 mg/dL and HbA1c by 0.5% in people with diabetes.

  • Another clinical trial showed that consuming 30 mL (2 tablespoons) daily for 8 weeks reduced blood glucose and improved insulin sensitivity.

⚠️ Note: Most of these benefits were observed from liquid ACV, not supplements. In fact, one study reported ACV tablets were less effective than the liquid version at improving blood sugar after meals.

2. Potential Support for Weight Loss

While claims about ACV aiding in weight loss are widespread, research is limited and mixed. Still, some evidence suggests it may play a small role:

  • A 12-week study of overweight individuals showed that those consuming 30 mL of ACV per day along with a calorie-restricted diet lost more weight than those dieting alone.

  • ACV may increase feelings of fullness, leading to lower calorie intake.

However, it’s unclear how much of the effect is due to ACV itself versus other lifestyle factors.

3. May Help Reduce Cholesterol

Preliminary studies suggest ACV could have modest effects on cholesterol:

  • Some trials found a small decrease in total cholesterol levels (~6 mg/dL).

  • However, ACV didn’t significantly affect LDL ("bad") or HDL ("good") cholesterol levels.

While the changes are mild, ACV could be part of a heart-healthy diet when combined with other measures.

4. Has Antimicrobial Properties

ACV has shown antimicrobial activity in lab studies:

  • It may inhibit harmful bacteria like E. coli and Staphylococcus aureus, including antibiotic-resistant strains like MRSA.

  • Both ACV liquid and tablets demonstrated some effectiveness at high concentrations in test environments.

⚠️ Important: These findings are from in vitro (test tube) studies—not human trials. ACV is not a replacement for antibiotics or medical treatment.

How to Take Apple Cider Vinegar

Forms Available

ACV is sold in several forms:

  • Liquid (most researched and commonly used)

  • Capsules and tablets

  • Gummies and powders

When to Take It

  • Before meals: May help control post-meal blood sugar spikes.

  • With food: To reduce appetite or support digestion.

Dosage

  • There’s no universal dose, but 15–30 mL (1–2 tablespoons) per dayof liquid ACV is common in studies.

  • If using supplements, follow product instructions and consult a healthcare provider for personalized advice.

Always dilute ACV in water or mix with food, as its high acidity can damage teeth and the esophagus if taken undiluted.

Is Apple Cider Vinegar Safe?

Short-Term Use

  • Generally safe in food amountsor when used short-term for medicinal purposes.

  • Most people tolerate small doses well.

Long-Term or Excessive Use Risks

  • Can cause low potassium levels (hypokalemia)

  • May erode tooth enamel and irritate the esophagus

  • Topical use may lead toskin burns

Pregnancy and Breastfeeding

  • Safety is unknown for medicinal use during pregnancy or breastfeeding.

  • Stick to food-based use only unless otherwise advised by a healthcare provider.

Potential Side Effects

Common side effects (especially with long-term or high use):

  • Nausea

  • Throat irritation

  • Tooth enamel erosion

  • Skin burns (when applied directly)

  • Low potassium (hypokalemia)

Drug and Supplement Interactions

Because ACV can affect potassium and blood sugar levels, it may interact with:

Medications:

  • Diuretics (e.g., furosemide)

  • Diabetes medications (e.g., metformin, insulin)

  • Digoxin (Lanoxin) – risk of enhanced toxicity due to lower potassium

Herbs and Supplements:

  • Licorice, horsetail, foxglove, and others that also lower potassium

  • Supplements that lower blood sugar, like bitter melon or chromium

If you're taking any medications or other herbal supplements, talk to a healthcare provider before starting ACV.

Can You Take Too Much?

Yes. Excessive intake—especially undiluted or in supplement form—can lead to:

  • Low potassium levels

  • Esophageal injury

  • Tooth enamel damage

  • Digestive upset

To stay safe, never exceed recommended doses, and always monitor for side effects.

A Quick Recap

Apple cider vinegar has gained popularity for its potential health benefits, including lowering blood sugar, supporting modest weight loss, and offering antibacterial properties. While these effects are promising, most evidence supports the liquid form, not supplements.

When taken appropriately, ACV is generally safe, but overuse or improper use can lead to side effects. Always dilute liquid ACV, and consult a medical provider if you're taking medications or have a health condition.