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Apple Cider Vinegar

What other names is Apple Cider Vinegar known by?

ACV, Cider Vinegar, Vinagre de Manzana, Vinagre de Sidra de Manzana, Vinaigre de Cidre.

What is Apple Cider Vinegar?

Apple cider vinegar is fermented juice from crushed apples. Like apple juice, it probably contains some pectin; vitamins B1, B2, and B6; biotin; folic acid; niacin; pantothenic acid; and vitamin C. It also contains small amounts of the minerals sodium, phosphorous, potassium, calcium, iron, and magnesium. Apple cider vinegar can also contain significant quantities of acetic acid and citric acid. It is used to make medicine.

Apple cider vinegar is taken by mouth alone or with honey for diabetes, indigestion (dyspepsia), delayed gastric emptying (gastroparesis), weak bones (osteoporosis), weight loss, leg cramps and pain, sore throats, sinus problems, high blood pressure, osteoarthritis, to help rid the body of toxins, stimulate thinking, slow the aging process, reduce cholesterol, and fight infection.

Some people apply apple cider vinegar to the skin for acne, as a skin toner, to soothe sunburn, for shingles, insect bites, and to prevent dandruff. It is also used in the bath for vaginal infections.

In foods, apple cider vinegar is used as a flavoring agent.

It can be hard to know what's in some apple cider vinegar products. Laboratory analysis of commercially available apple cider vinegar tablets shows wide variation in what they contain. Amounts of acetic acid ranged from about 1% to 10.57%. Amounts of citric acid ranged from 0% to about 18.5%. Amounts of ingredients listed on the product labels didn't match the laboratory findings. In the US, there is no real definition in the law of what apple cider vinegar must contain to be called apple cider vinegar. So, it is impossible to tell from these analyses whether these commercial products actually contain any apple cider vinegar.

Is Apple Cider Vinegar effective?

Glucosamine sulfate can improve pain and movement in knees affected by osteoarthritis. It seems to work about as well as some nonprescription pain medications. But glucosamine takes about twice as long to work, four weeks instead of two. There is some evidence that glucosamine sulfate may actually keep the joint problems from getting worse. Other pain relievers can reduce the pain but do not prevent the disease from slowly destroying more of the joint. Glucosamine sulfate might not be as effective for reducing pain in more severe, long-standing osteoarthritis.

Glucosamine sulfate is often marketed in combination products that also contain chondroitin sulfate. So far, there is no evidence that the combination products work any better than glucosamine sulfate or chondroitin sulfate alone. Buying a combination product is probably not worth the extra cost.

Effective for...

  • Indigestion. Taking calcium carbonate by mouth as an antacid is effective for treating indigestion.
  • High levels of potassium in the blood (hyperkalemia). Giving calcium gluconate intravenously (by IV) can reverse heart problems caused by hyperkalemia, a condition in which there is too much potassium in the blood.
  • Low levels of calcium in the blood (hypocalcemia). Taking calcium by mouth is effective for treating and preventing hypocalcemia. Also, giving calcium intravenously (by IV) is effective for treating very low levels of calcium.
  • Kidney failure. Taking calcium carbonate or calcium acetate by mouth is effective for controlling high phosphate levels in the blood in people with kidney failure. Calcium citrate is not effective for treating this condition.

QUESTION

Next to red peppers, you can get the most vitamin C from ________________. See Answer

Likely Effective for...

  • Reducing the risk of heart disease, when oat bran is used as part of a diet low in fat and cholesterol. Current FDA regulations and guidelines allow food products containing whole oats that provide 750 mg of soluble fiber per serving to be labeled with the health claim that the product may reduce the risk of heart disease when included as part of a diet low in saturated fat and cholesterol.
  • Lowering cholesterol. Eating oats, oat bran, and other soluble fibers can modestly reduce total and “bad” low-density lipoprotein (LDL) cholesterol when consumed as part of a diet low in saturated fat. For each gram of soluble fiber (beta-glucan) consumed, total cholesterol decreases by about 1.42 mg/dL and LDL by about 1.23 mg/dL. Eating 3-10 grams of soluble fiber can reduce total cholesterol by about 4-14 mg/dL. But there's a limit. Doses of soluble fiber greater than 10 grams per day don't seem to increase effectiveness.
    Eating three bowls of oatmeal (28 gram servings) daily can decrease total cholesterol by about 5 mg/dL. Oat bran products (oat bran muffins, oat bran flakes, oat bran Os, etc.) may vary in their ability to lower cholesterol, depending on the total soluble fiber content. Whole oat products might be more effective in lowering LDL and total cholesterol than foods containing oat bran plus beta-glucan soluble fiber.
    The FDA recommends that approximately 3 grams of soluble fiber be taken daily to lower blood cholesterol levels. However, this recommendation doesn't match research findings; according to controlled clinical studies, at least 3.6 grams of soluble fiber daily is needed to lower cholesterol.

Possibly Effective for...

  • Reducing blood sugar levels in people with diabetes when oat bran is used in the diet. Eating oats and oat bran for 6 weeks significantly decreases before-meal blood sugar, 24-hour blood sugar, and insulin levels in people with type 2 diabetes. There is some evidence that consuming 50 grams of oat bran daily, containing 25 grams of soluble fiber, might be more effective than the moderate fiber diet of 24 grams daily recommended by the American Diabetes Association.
  • Preventing stomach cancer when oats and oat bran are used in the diet.

Possibly Ineffective for...

Likely Ineffective for...

  • Enhancing athletic performance. Taking androstenedione by mouth in doses of 100-300 mg per day does not significantly increase muscle strength, muscle size, or lean body mass when used for 2-3 months in connection with weight training.

Ineffective for...

  • Cardiac arrest. Evidence suggests that administering calcium during cardiac arrest does not increase survival and might actually worsen the chance for resuscitation.

Insufficient Evidence to Rate Effectiveness for...

  • Diabetes. Early research shows that taking apple cider vinegar with a meal improves insulin sensitivity and insulin levels after the meal in people with insulin resistance. But it doesn't seem to have a significant benefit in people with type 2 diabetes.
  • Slow digestion (gastroparesis). Early research shows that taking apple cider vinegar worsens gastric emptying rate in people with type 1 diabetes and slow digestion.
  • Acne.
  • Arthritis.
  • Bites.
  • Dandruff.
  • High blood pressure.
  • Improving circulation.
  • Infection.
  • Leg cramps and pain.
  • Lowering cholesterol.
  • Shingles.
  • Sinus problems.
  • Sore throats.
  • Sunburn.
  • Unsettled stomach.
  • Vaginal infections (vaginitis).
  • Weak bones (osteoporosis).
  • Weight loss.
  • Other conditions.
More evidence is needed to rate apple cider vinegar for these uses.

SLIDESHOW

Vitamin D Deficiency: How Much Vitamin D Is Enough? See Slideshow

How does Apple Cider Vinegar work?

Apple cider vinegar is the fermented juice of crushed apples. It contains acetic acid and nutrients such as B vitamins and vitamin C. Apple cider vinegar might help lower blood sugar levels in people with diabetes by changing how foods get absorbed from the gut. Apple cider vinegar might prevent the breakdown of some foods.

Are there safety concerns?

Consuming apple cider vinegar in food amounts is LIKELY SAFE. Apple cider vinegar is POSSIBLY SAFE for most adults when used short-term for medical purposes. Apple cider vinegar is POSSIBLY UNSAFE when applied to the skin or when taken by mouth in large amounts, long-term.

Consuming large amounts of apple cider vinegar long-term might lead to problems such as low potassium. There has been one report of a person who developed low potassium levels and weak bones (osteoporosis) after taking 250 mL apple cider vinegar daily for 6 years. In another report, a woman who had an apple cider vinegar tablet lodged in her throat for 30 minutes developed tenderness and pain in her voice box and difficulty swallowing for 6 months following the incident. This was thought to be due to the acid content of the tablet.

Applying apple cider vinegar to the skin has been reported to cause chemical burns even after one use.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Not enough is known about the safety of using apple cider vinegar as medicine during pregnancy and breast-feeding. Stay on the safe side, and don't use it.

Diabetes: Apple cider vinegar might lower blood sugar levels in people with diabetes. Therefore, blood sugar levels need to be monitored closely. Dose adjustments may be necessary for diabetes medications that are taken.

Are there any interactions with medications?


Digoxin (Lanoxin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Large amounts of apple cider vinegar can decrease potassium levels in the body. Low potassium levels can increase the side effects of digoxin (Lanoxin).


InsulinInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Insulin might decrease potassium levels in the body. Large amounts of apple cider vinegar might also decrease potassium levels in the body. Taking apple cider vinegar along with insulin might cause potassium levels in the body to be too low. Avoid taking large amounts of apple cider vinegar if you take insulin.


Medications for diabetes (Antidiabetes drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Apple cider vinegar might decrease blood sugar in people with diabetes. Diabetes medications are also used to lower blood sugar. Taking apple cider vinegar along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.


Water pills (Diuretic drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Large amounts of apple cider vinegar can decrease potassium levels in the body. "Water pills" can also decrease potassium in the body. Taking apple cider vinegar along with "water pills" might decrease potassium in the body too much.

Some "water pills" that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Microzide), and others.

Dosing considerations for Apple Cider Vinegar.

The appropriate dose of apple cider vinegar depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for apple cider vinegar. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Reviewed on 9/11/2019
References

Krueger, D. A. and Krueger, H. W. Isotopic composition of carbon in vinegars. J Assoc Off Anal.Chem. 1985;68(3):449-452. View abstract.

Lhotta, K., Hofle, G., Gasser, R., and Finkenstedt, G. Hypokalemia, hyperreninemia and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80(2):242-243. View abstract.

Beheshti Z, Chan YH, Nia HS, et al. Influence of apple cider vinegar on blood lipids. Life Sci J. 2012;9(4):2431-2440.

Brighenti F, Castellani G, Benini L, et al. Effect of neutralized and native vinegar on blood glucose and acetate responses to a mixed meal in healthy subjects. Eur J Clin Nutr 1995;49:242-7. View abstract.

Budak NH, Kumbul Doguc D, Savas CM, et al. Effects of apple cider vinegars produced with different techniques on blood lipids in high-cholesterol-fed rats. J Agric Food Chem 2011;59:6638-44. View abstract.

Bunick CG, Lott JP, Warren CB, et al. Chemical burn from topical apple cider vinegar. J Am Acad Dermatol 2012;67(4):e143-4. View abstract.

Duke J. The Green Pharmacy. Emmaus: Rodale Press, 1997

Feldstein S, Afshar M, Krakowski AC. Chemical Burn from Vinegar Following an Internet-based Protocol for Self-removal of Nevi. J Clin Aesthet Dermatol. 2015 Jun;8(6):50. View abstract.

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 2005;105:1141-4. View abstract.

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 2007;7:46. View abstract.

Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care 2004;27:281-2. View abstract.

Lhotta K, Hofle G, Gasser R, Finkenstedt G. Hypokalemia, hyperreninemia, and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80:242-3.

Liljeberg H, Björck I. Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. Eur J Clin Nutr 1998;52:368-71. View abstract.

Nutrition Search. Nutrition Almanac, Revised Edition. New York: McGraw-Hill Book Company. 1979.

Shishehbor F, Mansoori A, Sarkaki AR, et al. Apple cider vinegar attenuates lipid profile in normal and diabetic rats. Pak J Biol Sci 2008;11:2634-8. View abstract.

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