Apple Cider Vinegar

Nearly every day, a patient asks about taking apple cider vinegar. What does current science have to say?

Apple cider vinegar is made with crushed apples, yeast, and sugar. The apple cider vinegar we find in most stores is a clear, pasteurized, and filtered fluid, and is commonly used as an ingredient in salad dressings, sauces, stews, pickles, and marinades.

Raw, unfiltered apple cider vinegar has a cloudy sediment and is made up of “good” bacteria, proteins, enzymes and yeast. In general, the darker the vinegar, the more antioxidants it has. It is also available as a supplement in the form of pills, powders, or gummies.

Apple cider vinegar has long been used as a home remedy for a variety of ailments. However, most studies have been small, and results have simply not been decisive. Here are some of the claims attributed to apple cider vinegar:

• The most popular use is to mix it with honey, and use it for coughs and respiratory conditions.

• Some claim that taking one or two tablespoons a day helps to lose a few extra pounds. The theory behind this is that the vinegar’s acetic acid might speed up metabolism.

• Others believe that apple cider vinegar might improve cholesterol levels (by increasing the good cholesterol HDL), and lower triglycerides.

• Small studies have reported that taking a tablespoon or two could slightly lower the blood sugar after meals.

• One study in rats suggests that apple cider vinegar could help lower high blood pressure, but there are no studies in humans.

• Many use it to reduce acid reflux.

• There is some evidence that apple cider vinegar, along with lemon juice, can keep bacteria from growing on salad greens.

Any downsides of using apple cider vinegar are mostly related to its acid content. It could be an irritant to the esophagus if drunk straight, or in excess. It could dissolve tooth enamel, give some people indigestion, or cause nausea. I would suggest that it not be taken on an empty stomach, and that it be diluted if it leads to heartburn. Be aware that it can interact with some drugs, including diuretics, laxatives, and insulin, and that it can lower potassium levels.

My bottom line? Apple cider vinegar is generally safe, useful in cooking, and may offer health benefits, however, significant health benefits have not been scientifically proven. I suggest that you inform your doctor if you are taking apple cider vinegar products.