Apple Cider Vinegar

Purported Benefits, Side Effects & More

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For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.

Apple cider vinegar (ACV) is made by fermenting apple juice. 

ACV supplements come as gummies, capsules, and tablets. It is also added to gels and creams to put on the skin, and to shampoos, serum, and hair rinses for healthy hair.

ACV is used:

  • To prevent heart disease
  • To treat diabetes
  • To lower cholesterol levels in those with high cholesterol 
  • For weight loss

Side effects of applying ACV on skin may include:

  • Burns
  • Scarring

For Healthcare Professionals

Apple cider vinegar (ACV) is an acidic solution produced by fermenting apple juice. It is used widely to flavor and preserve foods, and as a folk remedy for infections, insect bites, warts and scurvy. Recent claims of benefits include weight loss, sore throat, indigestion, glucose control in diabetes, dyslipidemia, arthritis, and skin conditions such as acne, eczema and dandruff.

Preclinical studies indicate ACV has antibacterial, antioxidant, anti-inflammatory, antidiabetic, and anti-hyperlipidemic effects (1) (2) (3) (4).

Although ACV is widely used for dermatological conditions, it was ineffective in treating atopic dermatitis (5) (6). Other findings suggest that ACV may help reduce the risk of cardiovascular diseases by regulating blood sugar and lipid levels (7) (8); improve glycemic control in patients with diabetes mellitus (9); and may help manage weight in overweight and diabetic adults (10). 
Overall, available evidence to support ACV use is not conclusive due to heterogeneity between studies, variations in duration, dosage, and different formulations. Larger, methodologically-robust trials are needed to generate more definitive data.

Of concern, ACV is being promoted as an alternative cancer treatment. A recent analysis of a popular search engine found it was among the ten most frequently mentioned natural remedies for skin cancer (11). But there is no scientific evidence that ACV can prevent or cure skin or any other type of cancer

  • Cardiovascular disease
  • Diabetes
  • Hypercholesterolemia
  • Weight Loss

The major components of ACV are polyphenolic compounds and acetic acid, which was shown to slow gastric emptying and increase the feeling of satiety, thereby reducing caloric intake in a murine model (12). It also improved the serum lipid profile in both normal and diabetic rats via lowering serum triglycerides and low-density lipoprotein-cholesterol (LDL-c) while elevating high-density lipoprotein-cholesterol levels (HDL-c)  (2).

Additionally, ACV was shown to mitigate liver injury induced by high-fat diet in mice by remodeling gut microbiota and restoring microbial metabolites (4). It also protected against erythrocyte, kidney, and liver oxidative injury, and reduced the serum lipid levels in mice that were fed a high-cholesterol diet by inhibiting lipid peroxidation and increasing the levels of antioxidant enzyme (3).

None known.

Case Reports

Hepatotoxicity: In a 60-year-old man with a history of vinegar consumption. His condition improved after stopping vinegar use (13).

Acute pancreatitis: In a 84-year-old woman, linked to use of a weight loss supplement containing ACV.  Her symptoms improved after symptomatic treatment and cessation of supplement use (14).

Chemical burns with topical use of ACV: In an 8-year-old boy, to treat a viral skin infection (bunick); In an infant, to lower body temperature (Korkmaz); In an 8-year-girl, to treat head lice infestation (15).

Scarring: In an 11-year-old girl, who used ACV topically to treat melanocytic nevus, a benign skin lesion (16).

Hypokalemia, hyperreninemia and osteoporosis: In a 28-year-old woman following excessive consumption of ACV (17).

Esophageal injury: In a 48-year-old woman after ingesting ACV tablets. Analysis of the tablets revealed high concentration of ACV (18).

None known.

  1. Fraise AP, Wilkinson MA, Bradley CR, Oppenheim B, Moiemen N. The antibacterial activity and stability of acetic acid. J Hosp Infect. Aug 2013;84(4):329-31. doi:10.1016/j.jhin.2013.05.001 
  2. Shishehbor F, Mansoori A, Sarkaki AR, Jalali MT, Latifi SM. Apple cider vinegar attenuates lipid profile in normal and diabetic rats. Pak J Biol Sci. Dec 1 2008;11(23):2634-8. doi:10.3923/pjbs.2008.2634.2638 
  3. Nazıroğlu M, Güler M, Özgül C, Saydam G, Küçükayaz M, Sözbir E. Apple cider vinegar modulates serum lipid profile, erythrocyte, kidney, and liver membrane oxidative stress in ovariectomized mice fed high cholesterol. J Membr Biol. Aug 2014;247(8):667-73. doi:10.1007/s00232-014-9685-5 
  4. Ding Q, Xue D, Ren Y, et al. Apple Cider Vinegar Powder Mitigates Liver Injury in High-Fat-Diet Mice via Gut Microbiota and Metabolome Remodeling. Nutrients. Jun 28 2025;17(13)doi:10.3390/nu17132157 
  5. Luu LA, Flowers RH, Kellams AL, et al. Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity. Pediatr Dermatol. Sep 2019;36(5):634-639. doi:10.1111/pde.13888
  6. Luu LA, Flowers RH, Gao Y, et al. Apple cider vinegar soaks do not alter the skin bacterial microbiome in atopic dermatitis. PLoS One. 2021;16(6):e0252272. doi:10.1371/journal.pone.0252272
  7. Hadi A, Pourmasoumi M, Najafgholizadeh A, Clark CCT, Esmaillzadeh A. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complement Med Ther. Jun 29 2021;21(1):179. doi:10.1186/s12906-021-03351-w
  8. Tehrani SD, Keshani M, Rouhani MH, Moallem SA, Bagherniya M, Sahebkar A. The Effects of Apple Cider Vinegar on Cardiometabolic Risk Factors: A Systematic Review and Meta-analysis of Clinical Trials. Curr Med Chem. 2025;32(11):2257-2274. doi:10.2174/0929867331666230822102021
  9. Arjmandfard D, Behzadi M, Sohrabi Z, Mohammadi Sartang M. Effects of apple cider vinegar on glycemic control and insulin sensitivity in patients with type 2 diabetes: A GRADE-assessed systematic review and dose-response meta-analysis of controlled clinical trials. Front Nutr. 2025;12:1528383. doi:10.3389/fnut.2025.1528383
  10. Castagna A, Ferro Y, Noto FR, et al. Effect of Apple Cider Vinegar Intake on Body Composition in Humans with Type 2 Diabetes and/or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. Sep 19 2025;17(18)doi:10.3390/nu17183000
  11. Ezekwe U, Quartey A, Zheng S, Khachemoune A. Reappraisal of Alternative Treatments for Non-melanoma Skin Cancers on YouTube: A Cross-Sectional Analysis. Cureus. Aug 2025;17(8):e90522. doi:10.7759/cureus.90522
  12. Hlebowicz J, Darwiche G, Björgell O, Almér LO. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterol. Dec 20 2007;7:46. doi:10.1186/1471-230x-7-46
  13. Andonie CR, AbuGhannam SI, Ruzayqat SMA. Apple Cider Vinegar-Induced Hepatotoxicity: A Rare Case Report. Oxf Med Case Reports. Jul 2025;2025(7):omaf097. doi:10.1093/omcr/omaf097
  14. Alvarez L, Colaco LB, Ali S, et al. Unveiling a Sour Truth: Acute Pancreatitis Linked to Apple Cider Vinegar Supplement. ACG Case Rep J. Sep 2024;11(9):e01482. doi:10.14309/crj.0000000000001482
  15. Benmeir P, Lusthaus S, Weinberg A, Neuman A, Eldad A. Facial chemical burn. Burns. Jun 1994;20(3):282. doi:10.1016/0305-4179(94)90206-2
  16. Ashchyan H, Jen M, Elenitsas R, Rubin AI. Surreptitious apple cider vinegar treatment of a melanocytic nevus: Newly described histologic features. J Cutan Pathol. Apr 2018;45(4):307-309. doi:10.1111/cup.13102
  17. Lhotta K, Höfle G, Gasser R, Finkenstedt G. Hypokalemia, hyperreninemia and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron. Oct 1998;80(2):242-3. doi:10.1159/000045180
  18. Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. Esophageal injury by apple cider vinegar tablets and subsequent evaluation of products. J Am Diet Assoc. Jul 2005;105(7):1141-4. doi:10.1016/j.jada.2005.04.003
  19. Abou-Khalil R, Andary J, El-Hayek E. Apple cider vinegar for weight management in Lebanese adolescents and young adults with overweight and obesity: a randomised, double-blind, placebo-controlled study. BMJ Nutr Prev Health. 2024;7(1):61-67. doi:10.1136/bmjnph-2023-000823
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