Reviewed by Brunilda Nazario, MD on December 29, 2022

Vinegar is a sour liquid containing acetic acid that is made via fermentation from a vast range of ingredients. You can find vinegar in the cuisines of a wide variety of cultures. Many groups around the world make some type of vinegar, either to use as a condiment or to help preserve other foods.

To make vinegar, a sugar source like apple or barley is fermented and turned into alcohol. The liquid is then fermented again, which converts the alcohol into acid. The result is a sour and sometimes sweet product that helps flavor food or preserve it from bacteria.


Apple cider vinegar (ACV) is a type of vinegar made with crushed apples, yeast, and sugar. It's used as an ingredient in foods like salad dressings, pickles, and marinades.

For many years, people have also used it as a home remedy for everything from fighting germs to preventing heartburn. More recently, research has shown that apple cider vinegar might have some real health benefits, such as helping to reduce blood sugar levels and aid weight loss.

While there's not a lot of evidence for these benefits, ACV is generally harmless – as long as you use it correctly.

Apple cider vinegar is made through a process called fermentation. The yeast in the mixture digests the sugar in the apple juice, turning it into alcohol after a few weeks. Then, natural bacteria break the alcohol down into acetic acid, which gives vinegar its tangy taste and odor.

Most ACV you find in the grocery store is the clear, pasteurized, and filtered type. But you can also buy raw, unfiltered apple cider vinegar that contains a cloudy sediment. Called “the mother,” this substance is made up of settled bacteria and yeast.

Some people give the mother credit for ACV's health benefits. And it's thought to contain small amounts of probiotics, healthy bacteria that are good for gut health. But research hasn’t shown that the mother offers any particular health benefit.

The acetic acid in ACV is also thought to be at least partly responsible for any health benefits it has. But other types of vinegar contain acetic acid as well.

You can also buy apple cider vinegar pills, powders, or gummies. But there's been little research into whether these supplements have any effect. And because the FDA doesn't regulate dietary supplements, you can't be sure exactly what's in them.

Vinegar is an excellent source of:

 Some kinds of vinegar can also be a good source of antioxidants. The darker the vinegar, the more antioxidants remain in the liquid. A darker vinegar is generally less refined than lighter vinegar types, with healthy compounds in the liquid affecting taste and color. 

Most studies that support ACV for health effects have been small, and the results have not been decisive. We need more and bigger investigations into its benefits. But so far, here's what research has found:

It may help with weight loss. One study showed that taking apple cider vinegar twice a day helped people following a reduced-calorie diet lose a few extra pounds. But the study was small and short-term, following 39 people for 12 weeks.

Some researchers thought the vinegar's acetic acid might speed up metabolism. But the data didn't bear this out. It may be that people lost more weight because of the placebo effect. Or perhaps the acetic acid made them nauseated, which caused them to eat less.

It may lower blood sugar. Several smaller studies have shown that taking a tablespoon or two of apple cider vinegar could lower your blood sugar after meals. The effect was moderate, and we need more research to know exactly how it works. Keep in mind that apple cider vinegar can't replace diabetes medications and a healthy lifestyle. But it should be safe to add to your treatment plan.

It may lower cholesterol. The same small study that showed ACV boosted weight loss also found that it lowered the total cholesterol levels of study subjects who took it. It also increased their "good" cholesterol and lowered levels of triglycerides (fats in the blood). Other studies have had similar findings. Experts caution that we need more research to fully understand this link.

People also use apple cider vinegar for purposes that haven't been researched much, or haven't been shown to be effective. Some of these uses include:

Lower blood pressure. One study in rats suggests that ACV could help with high blood pressure. But no studies done in humans back this up. And high blood pressure can be a serious condition. So medical treatment and a healthy lifestyle are essential.

Ease acid reflux. Many people swear by ACV as a remedy for heartburn and acid reflux. But there's no research to show it's effective. Ask your doctor if you could try ACV to ease your discomfort. Start with small amounts, diluted in water.

Eczema relief. Some people with eczema use ACV to ease their skin symptoms. But some studies found it had little effect and irritated some people's skin. Ask your dermatologist if it's OK for you to try ACV.

Kill germs. While there's some evidence that ACV (along with lemon juice) can keep bacteria like salmonella from growing on salad greens, it doesn't protect wounds against infection.

Hair health. Some people use apple cider vinegar as a hair rinse to ease dandruff or remove product buildup. There's no proof it works for these things. But ACV does contain things that fight bacteria and fungi, which could promote hair health.

If you have hard water, apple cider vinegar may ease some of its effects. Hard water is high in minerals like calcium, magnesium bicarbonate, and sulfates. Apple cider vinegar is thought to help get rid of calcium buildup and leave your hair shinier when you use it after a shampoo.

It's safe and tasty to use ACV to add some excitement to your meals. Use it to liven up sauces and stews as well as traditional salad dressings and marinades.

You can also drink apple cider vinegar, diluted in hot or cold water as you prefer. Some people drink it before or after meals, or before going to bed.

If you take an ACV pill, tablet, powder, or gummy, start by asking your doctor how much you should take. And follow the package instructions, as dosages may vary by brand. Your safest bet is to look for brands with a stamp from the Banned Substances Control Group (BSCG), Informed Choice, ConsumerLab, United States Pharmacopeia (USP), NSF Certified for Sport, or NSF International.

If your doctor gives you the OK to try ACV for eczema, do a patch test first. Apply ACV to a small area of skin, then wait a few days to see if any irritation happens. You could then try it in:

  • A bath. Add 2 cups of ACV to a tubful of lukewarm water. Soak for 15 to 20 minutes. Rinse your body well with cool water and moisturize with a scent-free lotion.
  • A wet wrap. Make a solution with 1 cup of warm water and 1 tablespoon of ACV. Soak gauze or pieces of clean cotton fabric in the solution. Put the wet cloths on your skin, then cover them with clean, dry cotton fabric. Leave them on for 3 hours or overnight.

To use ACV as a hair rinse, put it on your hair after you shampoo. Leave it in for 5 minutes, then rinse. Don't use it more than once a week, as daily use can dry out your hair.

Diluting ACV makes it less irritating to your scalp and skin. Some beauty websites suggest mixing ACV with equal parts water; others recommend adding 2 to 4 tablespoons to 2 cups of water. It's probably safest to start with a weaker solution.

Because we still have a lot to learn about apple cider vinegar, there aren’t any official dosage suggestions. But some studies have given clues about the amount of apple cider vinegar that may help with certain health conditions:

Weight control. In the study that found weight loss benefits, people drank about 2 tablespoons of ACV a day – one before lunch and the other before dinner. Experts say that amount should be safe for most people.

Blood sugar and cholesterol control. People in the study saw improvement when they took about 1½ tablespoons of apple cider vinegar after a meal.

Acid reflux. A teaspoon or two of ACV diluted in a mug of warm water after a meal may help with your acid reflux. It's unlikely to make your condition worse.

Since it’s high in acid, apple cider vinegar could irritate your esophagus (the tube that connects your throat and stomach) if you drink it straight or drink too much of it. Undiluted ACV can also break down tooth enamel.

To avoid these issues, always water down apple cider vinegar and drink it through a straw to protect your teeth. (ACV in food generally doesn't have these effects.)

Apple cider vinegar may give some people indigestion or make them feel nauseated. Don't drink it on an empty stomach, and if you feel sick or throw up after you take it, stop using it.

ACV can also interact with some drugs, such as diuretics, laxatives, and insulin. Always ask your doctor if it’s safe to use apple cider vinegar with your current medications.

If you have low potassium levels (hypokalemia), too much ACV could make the condition worse. That's because large amounts of ACV can decrease potassium levels. Avoid overuse of ACV if you have kidney disease, since your kidneys might not be able to handle high levels of acid.

Show Sources


Cleveland Clinic: “Exploring the Health Benefits of Apple Cider Vinegar,” “Can Apple Cider Vinegar Help with Weight Loss?” “Is Apple Cider Vinegar Good for Acid Reflux?”

University of Chicago Medicine: “Debunking the Health Benefits of Apple Cider Vinegar.”

International Journal of Medical Research and Health Sciences: “Effect of Apple Cider Vinegar on Glycemic Control, Hyperlipidemia and Control on Body Weight in Type 2 Diabetes Patients.”

International Society of Pediatric Dermatology: “Apple Cider Vinegar Soaks [0.5%] as a Treatment for Atopic Dermatitis Do Not Improve Skin Barrier Integrity.”

University of Mississippi Medical Center: “Can a taste of apple cider vinegar a day keep the doctor away?”

Nutrition Reviews: “Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight.”

Central Research Institute: “Vinegar Intake Reduces Body Weight, Body Fat Mass, and Serum Triglyceride Levels in Obese Japanese Subjects.”

National Eczema Association “Get the Facts: Apple Cider Vinegar.”

Piedmont Healthcare: “Will apple cider vinegar help you lose weight?” “How To Best Wash Your Hair With Hard Water.”

Journal of Functional Foods: "Beneficial effects of Apple Cider Vinegar on weight management, Visceral Adiposity Index and lipid profile in overweight or obese subjects receiving restricted calorie diet: A randomized clinical trial."

Penn Medicine: "Does Apple Cider Vinegar Help You Lose Weight?"

BMC Complementary Medicine and Therapies: "The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials."

West Virginia University Extension Service: "Apple Cider Vinegar Myths & Facts."

Poison Control: "Vinegar Is Not Always Safe."

Antioxidants: “On the Characterization and Correlation of Compositional, Antioxidant and Colour Profile of Common and Balsamic Vinegars.”

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