Apple Cider Vinegar and Gut Inflammation: What the Research Says

Apple Cider Vinegar (ACV) and gut inflammation have been trending among the health-conscious for a long time. ACV has been hailed as a cure-all tonic in the natural health world—credited with everything from aiding digestion to detoxifying the body. But what does the science say, especially when it comes to gut health? In this post, we’ll explore how ACV is made, its potential benefits, and what it really does to your gut microbiome and digestion.

What Is Apple Cider Vinegar and How Is It Made?

Apple cider vinegar is a fermented liquid made from crushed apples, sugar, and yeast. The fermentation process happens in two stages:

1. Alcohol fermentation – Yeast breaks down the natural sugars in apple juice into alcohol.
2. Acetic acid fermentation – Acetic acid bacteria convert alcohol into acetic acid, the main active compound in vinegar.

The unfiltered version, aka “raw apple cider vinegar” often contains the “mother”, a cloudy, web-like substance made up of strands of proteins, enzymes, and beneficial bacteria.

Health Benefits of Apple Cider Vinegar

ACV contains vitamins, minerals, amino acids and polyphenols such as flavonoids, which are believed to contribute to its potential health benefits.

Used for centuries—dating all the way back to 3300 B.C.—apple cider vinegar has a long history as a natural remedy for everything from wound healing and infections to scurvy and insect bites. It was even valued for boosting overall health, strength, and vitality. Fast forward to today, and ACV is still making headlines. It’s been linked to benefits like clearer skin (think acne, eczema, and dandruff), better digestion, improved cholesterol levels, weight management, kidney stone prevention, stronger bones, blood sugar balance, and even healthy ageing, brain function, and physical performance.

Scientific evidence suggests that ACV is associated with several health benefits:

• Blood lipid and sugar control: ACV improves insulin sensitivity and reduces blood cholesterol levels and blood sugar levels.
• Weight loss and management: It may promote satiety, leading to reduced calorie intake.
• Antimicrobial properties: ACV has been used traditionally to help fight infections. It has displayed anti-microbial activity against antimicrobial-resistant pathogenic bacteria
• Heart health: Clinical studies suggest that ACV can lower cholesterol and high blood pressure, helping to reduce the risk of heart disease.

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Apple Cider Vinegar and Gut Inflammation: The Science Involved

1. Impact on Gut Microbiome

Raw, unfiltered ACV contains probiotics (beneficial bacteria), especially when it includes the “mother.” These may support gut microbial diversity, although the concentration is much lower than in fermented foods like yogurt or kefir. ACV also increases the amount of starch available for gut bacteria by inactivating the enzymes that digest starch.

2. Digestive Aid

The acetic acid in ACV may increase stomach acidity, helping to digest proteins more efficiently. It may also promote the release of digestive enzymes and bile, helping with digestive issues.

3. Anti-inflammatory action

Vinegar is well known for its anti-inflammatory action due to its acetic acid content. The intestine absorbs it and it soon reaches the bloodstream and is circulated all over the body. Apple cider vinegar not only aids in reducing gut inflammation but also helps settle systemic inflammation.

Using ACV for Gut Inflammation

If you’re new to ACV for gut inflammation, start slow. It is advisable to start with small amounts and gradually increase them over time. Here are some general guidelines:

• Dosage: Dilute 1 to 2 teaspoons (5–10 mL) of ACV in a large glass of water (200-250 ml), once or twice daily. I prefer to have mine diluted in a cup of warm water on an empty stomach early in the morning.
• Timing: If you prefer to have it later in the day, schedule it 15–30 minutes before meals to aid digestion.
• Never consume undiluted: As ACV is acidic, it can erode tooth enamel and irritate your throat or stomach lining. So never consume it undiluted.

Ways to Incorporate Apple Cider Vinegar in Your Diet

• Drink: Combine ACV with water, lemon juice, and a touch of honey for a gut-friendly drink. You can have it warm or topped with ice.
• Salad dressings: ACV tastes amazing in dressings. You can use it in any recipe that requires vinegar. I combine one tablespoon of ACV with three tablespoons of olive oil, and whisk it along with mustard, honey, and herbs.
• Fermented veggie pickle brine: My family loves homemade pickles. It’s a great way to encourage kids to eat carrots, beets, and cucumbers. Using apple cider vinegar in the pickle enhances the taste and is also beneficial for the gut.
• Gut-friendly tonic: For a gut-friendly tonic, mix a teaspoon of apple cider vinegar with warm water, cinnamon, and ginger.

ACV in Specific Medical Conditions

1. Kidney Disease

Apple cider vinegar is often promoted as a detox tonic, but if you have kidney disease, it’s important to tread carefully. ACV is high in acetic acid, which can be too harsh for kidneys that are already compromised. In people with chronic kidney disease (CKD) or impaired kidney function, the body may struggle to handle the acid load, potentially worsening metabolic acidosis or irritating kidney tissue. It can also cause low potassium levels and should be avoided in patients who are prone to hypokalemia.

That said, for those with healthy kidneys, ACV in moderate, diluted amounts is generally considered safe and may even help prevent kidney stones by increasing stomach acid and improving calcium absorption

2. Inflammatory Bowel Disease (IBD)

Conditions like Crohn’s disease and ulcerative colitis involve chronic inflammation of the gut lining. While ACV has some anti-inflammatory and antimicrobial properties, there’s no substantial evidence to support its use in IBD. In fact, its acidity may irritate an already inflamed gut, especially during flare-ups.

Bottom line is that ACV isn’t a treatment for IBD and may do more harm than good during active symptoms. If you’re considering it, check in with your gastroenterologist first.

3. Irritable Bowel Syndrome (IBS)

If you’re living with IBS, you know how unpredictable digestion can be. Some people report that apple cider vinegar helps ease bloating and indigestion, possibly by boosting stomach acid and supporting digestion. But the evidence is mostly anecdotal. For others, the acidity of ACV can actually worsen symptoms like reflux, gas, or abdominal pain.

If you want to try ACV for IBS, start with a small, diluted amount (1 tsp in a full glass of water) and see how your body responds. Everyone’s gut reacts differently.

Possible Side Effects of Apple Cider Vinegar

While ACV is generally safe in moderation, it’s not without risks, especially if taken in excessive amounts, undiluted and too frequently. Some of the side effects to watch out for are:

• Tooth enamel erosion due to its acidity.
• Throat irritation if taken undiluted.
• Digestive upset in some individuals (especially those with acid reflux).
• Drug interactions – may affect insulin or diuretic medications.

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Bottom Line

Apple cider vinegar can be a helpful addition to a gut-friendly lifestyle when used wisely. It may support digestion, offer mild probiotic benefits, and help with blood sugar balance. However, it’s not a miracle cure, and not a replacement to a balanced diet or medical treatment. It should be used with care, especially by those with pre-existing conditions like kidney disease or IBD.

Start small. Dilute well. Listen to your body. And when in doubt, check with your healthcare provider.