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Medically reviewed by Robert Burakoff, MD
Key Takeaways
- Apple cider vinegar is thought to reduce the risk of metabolic dysfunction-associated steatotic liver disease (MASLD), though the evidence is weak.
- While generally safe, apple cider vinegar can cause indigestion, nausea, throat irritation, and tooth erosion.
While some studies suggest that apple cider vinegar (ACV) may benefit liver health, particularly in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD), the evidence is generally weak. ACV does not "detox" the liver, as some might claim, and can even lead to potassium deficiency or liver injury if overused.
Potential Benefits of Apple Cider Vinegar for the Liver
Some people believe apple cider vinegar offers many health benefits. One potential benefit is the reduction of risk for metabolic dysfunction-associated steatotic liver disease, previously known as non-alcoholic fatty liver disease (NAFLD).
MASLD, which affects around one in every three people in the United States, is caused by the buildup of fat in the liver, leading to scarring and the progressive loss of liver function.
ACV is thought to help in several key ways.
Improved Gut-Liver Health
MASLD is closely linked to an imbalance of "good" and "bad" bacteria in the gastrointestinal tract, a condition known as gut dysbiosis
This imbalance can lead to the overgrowth of bacteria that release toxins into the bloodstream. The liver filters these toxins, resulting in inflammation. These bacteria can also affect how the liver breaks down lipids (blood fats), which contributes to fat accumulation and the onset of MASLD.
Some animal studies suggest that compounds in ACV, like acetic acid and polyphenols, may improve lipid metabolism and reduce liver fat.
Improved Insulin Sensitivity
Insulin resistance happens when the body doesn't respond well to insulin, making it difficult for glucose (blood sugar) to enter cells for energy. This condition can also affect liver function, impairing how it breaks down fat.
The impairment can cause the liver to produce excessive amounts of lipids, known as very low-density lipoprotein (vLDL) cholesterol, that directly contribute to fat buildup in the liver.
Some studies suggest that ACV can counter these effects, leading to improved glucose and lipid control as well as reduced liver fat.
Antioxidant Effects
Antioxidants are substances that help neutralize unstable molecules (free radicals) that damage DNA in cells. Plant-based compounds called polyphenols are the primary antioxidants in ACV, which include chlorogenic acid, gallic acid, and catechin.
Studies in mice suggest that these antioxidants can minimize liver injury caused by high-fat diets by blocking free radicals that spur liver inflammation. Doing so may theoretically prevent MASLD or help preserve liver function in those with MASLD.
How Effective Is Apple Cider Vinegar in Preventing MASLD?
The evidence supporting the benefits of ACV for people with MASLD is limited. Most of the current research is constrained to animals, and those involving humans are typically small and of poor quality.
Even so, a 2020 review of studies in BMC Complementary Medicine and Therapies reported that people who consumed ACV daily experienced significant improvements in their total cholesterol and fasting glucose levels. The effect was seen to be greatest in those with type 2 diabetes.
With that said, the daily consumption of ACV did not appear to have any effect on a person's insulin or low-density lipoprotein (LDL) levels, questioning the protective effect of ACV against conditions like MASLD.
Ask a Healthcare Provider
Talk with a healthcare provider before you use apple cider vinegar to prevent or treat any health condition. They can advise effective ways to manage your health risks and ensure your underlying conditions are treated.
How Much Apple Cider Vinegar Is Safe to Use?
When consumed in moderation, ACV is generally safe and may exert positive effects on both cholesterol and blood sugar levels. Studies have found that consuming 15 milliliters (mL)—or roughly one tablespoon—of ACV daily exerted the greatest potential benefits with the least risk of side effects.
Common side effects of ACV include:
- Indigestion
- Nausea
- Throat irritation
These effects can be eased by diluting 1 tablespoon of ACV in 8 ounces of water.
Possible Risks and Considerations
More is not better when it comes to using ACV for therapeutic purposes, such as a "liver detox." The liver is an amazing organ that detoxifies itself, and ACV in no way helps clear "toxins" caused by unhealthy eating or heavy drinking.
In fact, consuming large quantities of ACV can have potentially serious consequences, including:
- Tooth enamel erosion
- Esophageal sores and burns
- Interactions with drugs like insulin, diuretics (water pills), and digoxin
In very rare instances, the overuse of ACV has led to hypokalemia (low blood potassium), resulting in muscle cramps, bone mineral loss, and abnormal heart rhythms.
Even rarer is the risk of ACV-induced hepatoxicity (liver poisoning), a potentially fatal condition reported in adults who either drank a single, massive, undiluted dose or larger doses over many years.
Read the original article on Verywell Health
