Is apple cider vinegar really a cure-all?

On TikTok, a man swirls a tablespoon of apple cider vinegar into a cup of water, drinks it and eats two slices of pizza. Then, he tests his blood sugar. “These are the best results of all,” he says, showing a much lower spike on a blood sugar graph than when he ate the pizza without the vinegar.

In other posts, TikTok users rave about apple cider vinegar’s remarkable ability to help them lose weight, settle their stomachs and — when applied to their skin — clear their acne and eczema.

Apple cider vinegar has been used as a home remedy for healing wounds, quelling coughs and soothing stomachaches for thousands of years, said Carol Johnston, a professor of nutrition at Arizona State University.

But while some of apple cider vinegar’s health claims have a little science behind them, Johnston said, many claims haven’t been studied at all. Here’s what we know about apple cider vinegar — and some important cautions to keep in mind if you try it.

How might apple cider vinegar benefit health?

Apple cider vinegar is made via fermentation, in which yeast and bacteria convert carbohydrates first into alcohol and then into acetic acid, which gives vinegar its pungent taste and odour and potentially, research suggests, its health benefits, Johnston said.

Social media proponents often recommend using unpasteurised and unfiltered versions, which contain a haze of bacteria and undigested carbohydrates called “the mother,” said Dr Chris Damman of the University of Washington School of Medicine. But there’s no evidence that these “raw” apple cider vinegars are healthier than regular ones, he said.

Vinegars made from apples and other fruits also contain compounds called polyphenols, which have antioxidant and anti-inflammatory properties and might contribute to their potential health benefits, he said.

Blood sugar control

In the early 2000s, Johnston, who had been studying how certain diets could help manage Type 2 diabetes, came across a study from 1988 showing that acetic acid could lower blood sugar spikes in rats after they were given a starch solution. She was intrigued and decided to test the idea in people with Type 2 diabetes and insulin resistance.

Since then, Johnston and other researchers have found in small limited studies that drinking 1 to 2 tablespoons of apple cider or other types of vinegar mixed with water just before high-carbohydrate meals resulted in less drastic blood sugar spikes than meals without vinegar did.

Weight loss

Several small, short-term studies in adults who were classified as overweight or obese have found associations between apple cider vinegar and weight loss. In a 2009 study of 155 adults in Japan, for instance, researchers found that those who drank 2 tablespoons of apple cider vinegar in water every day for three months lost about 4 pounds. And in one 2024 trial of 120 people ages 12 to 25 in Lebanon, researchers reported that those who took 1 tablespoon of apple cider vinegar with water each morning for three months lost an average of 15 pounds.

But the one study that tracked participants after they stopped taking apple cider vinegar found that, on average, they regained most of the weight within a month. And just as many studies on similar groups of people have found no links to weight loss.

Given the lack of robust data and the short time frames of the studies, Beth Czerwony, a dietitian at the Cleveland Clinic, said that she did not recommend that her patients use apple cider vinegar for weight loss.

If vinegar does indeed help people lose weight, it may do so by slowing digestion, which can make you feel fuller for longer, she said.

Gut health

Tamara Duker Freuman, a dietitian in New York City who specialises in digestive conditions, said that many of her patients remark that drinking apple cider vinegar before or after meals reduces their symptoms of acid reflux.

Unfortunately, there’s no good research on vinegar and digestive health, said Dr Nitin K Ahuja, a gastroenterologist at Penn Medicine. People who use vinegar to treat reflux, which is commonly caused by stomach acid escaping into the esophagus, say that the acid from the vinegar prompts the stomach to produce less acid, Ahuja said. But, he added, there’s no supportive data, and “mechanistically, it doesn’t make sense” that adding acid to the stomach will somehow help to control it. If you have frequent or severe reflux symptoms, get treatment from a doctor, he said.

Skin conditions

After a study, Dr Lydia Luu, a dermatologist at the University of Virginia School of Medicine, said apple cider vinegar “is not very helpful for eczema, unfortunately — and could make your symptoms worse."

Is it safe to try?

Consuming apple cider vinegar, even when diluted, can interact with certain medications, including some drugs for diabetes and the heart, as well as diuretics. Apple cider vinegar may also lower blood potassium, which can be a problem for those who already have low levels, Czerwony said. So check with your doctor before trying it, she said.

If you want to use vinegar to control your blood sugar, Johnston suggested diluting 1 or 2 tablespoons of any type of vinegar into water and drinking, but don’t exceed 2 to 4 tablespoons in a day. Even when diluted, vinegar can erode tooth enamel, so she recommended drinking the vinegar with a straw.

If you drink it undiluted, you run the risk of corroding your esophagus lining too, Ahuja said. “Don’t just shoot it,” Johnston added.

A safer and tastier approach, Damman suggested, is to use apple cider vinegar in your cooking. Mix it into a vinaigrette or sushi rice, pair with olive oil as a dip for bread, or incorporate it into a refreshing fizzy drink. If there are any health benefits to be reaped, he said, you’ll likely get them this way, too. — The New York Times