Apple Cider Vinegar Interactions Overview

Additional Details

Is Apple Cider Vinegar Safe? Are There Any Warnings?

Caution: Apple cider vinegar should not be confused with Apple or Apple Polyphenols.

Overview: Apple cider vinegar is the fermented juice from crushed apples. It contains pectin, vitamins, minerals, and acid in the form of acetic acid or citric acid. While it is commonly used in salad dressings and cooking, apple cider vinegar has also been used for wound disinfection.

Warnings: There is no good evidence to support using apple cider vinegar for COVID-19. It is recommended to focus on healthy lifestyle choices and proven prevention methods instead.

Safety: Apple cider vinegar is generally considered safe when used orally in food amounts. Short-term use for medicinal purposes has also been deemed safe in studies lasting up to 12 weeks. However, caution should be exercised when using it topically or consuming large amounts of apple cider vinegar over a long period of time.

Adverse Effects: In general, apple cider vinegar is well tolerated in food amounts. However, topical application can cause chemical burns and skin irritation. Long-term oral use has been associated with hypokalemia, hyperreninemia, and osteoporosis in rare cases.

How Is Apple Cider Vinegar Thought To Work? What Is the Mechanism of Action?

Mechanism of Action: Apple cider vinegar contains various nutrients such as pectin, vitamins (B1, B2, B6, biotin, folic acid, niacin, pantothenic acid, and vitamin C), and minerals (sodium, phosphorous, potassium, calcium, iron, and magnesium). It also contains acetic acid and citric acid, albeit in varying amounts. These components can differ depending on the production method.

Antidiabetic effects: Apple cider vinegar has been found to reduce glycated hemoglobin (HbA1C) in animals with diabetes. In humans, it can increase insulin sensitivity and lower postprandial glucose levels. The exact mechanisms are not fully understood, but it is believed that apple cider vinegar delays gastric emptying, inhibits carbohydrate breakdown, and influences glucose metabolism.

Antioxidant effects: Apple cider vinegar produced through traditional methods has shown greater antioxidant activity compared to industrial-produced vinegar.

Dermatological effects: Topical application of apple cider vinegar has shown promise in inhibiting the growth of Staphylococcus aureus and improving symptoms of atopic dermatitis in animal models. However, its effects on human skin microbial diversity are still inconclusive.

Lipid effects: Regular consumption of apple cider vinegar has been associated with increased levels of high-density lipoprotein (HDL) cholesterol and decreased levels of triglycerides. However, its impact on other lipid markers varies.

Neurological effects: Apple cider vinegar has shown some potential in improving depressive mood, although the exact mechanism is not well understood.

Renal effects: Apple cider vinegar has been theorized to have preventive effects against kidney stones due to its potential to alkalinize urine and exhibit anti-inflammatory activity. However, more clinical evidence is needed to confirm this association.

Weight loss effects: Some studies suggest that apple cider vinegar may increase feelings of fullness and energy expenditure, but its direct impact on weight loss is still uncertain.

Pharmacokinetics

There is currently insufficient reliable information available regarding the pharmacokinetics of apple cider vinegar.

Interaction Overview

Interactions with Drugs:

• Antidiabetes drugs: Taking apple cider vinegar with antidiabetes drugs may increase the risk of hypoglycemia.
• Digoxin (Lanoxin): Concomitant use of apple cider vinegar with digoxin may increase the risk of cardiac toxicity.
• Diuretic drugs: Concomitant use of apple cider vinegar with diuretic drugs may increase the risk of hypokalemia.
• Insulin: Concomitant use of apple cider vinegar with insulin may increase the risk of hypokalemia.

Interactions with Supplements:

• Cardiac glycoside-containing herbs: Apple cider vinegar may theoretically increase the risk of cardiac toxicity when used with these herbs.
• Herbs and supplements with hypoglycemic potential: Apple cider vinegar may theoretically increase the risk of hypoglycemia when used with these substances.
• Horsetail: Apple cider vinegar may theoretically increase the risk of hypokalemia when used with horsetail.
• Licorice: Apple cider vinegar may theoretically increase the risk of hypokalemia when used with licorice.
• Stimulant laxative herbs: Apple cider vinegar may theoretically increase the risk of potassium depletion when used with these herbs.

Interactions with Conditions:

• Gastroparesis
• Hypokalemia

Common Side Effects To Watch For

Some common side effects associated with apple cider vinegar include mild skin irritation and gastrointestinal discomfort. However, serious adverse effects such as chemical burns and hypokalemia are rare. If any severe or persistent side effects occur, it is recommended to seek medical attention.

Are Supplements Standardized?

Apple cider vinegar is available in various forms, including liquid, tablets, and gummies. Liquid apple cider vinegar for food is often standardized based on acidity content, typically ranging from 4% to 8% acidity. However, the contents and acidity of commercially available apple cider vinegar tablets may vary significantly. It is important to note that there is no regulatory standard for identifying vinegar products in the U.S., making it challenging to determine the actual composition of these commercial products.

Apple cider vinegar can be produced through different methods, such as the artisanal and commercial/industrial processes. The artisanal method

Drugs that interact with Apple Cider Vinegar