Apple Cider Vinegar and Fatty Liver: Fact vs. Fiction

Could an item from your pantry help you manage fatty liver disease? Early research in mice and small groups of people suggests that apple cider vinegar (ACV) – in moderation – may benefit some people who have metabolic-associated fatty liver disease (MAFLD) and metabolic-associated steatohepatitis (MASH). Studies suggest that moderate use may improve lipid profiles (cholesterol numbers) and blood sugar control. Adding ACV to your diet can be as simple as drinking a glass of water with a tablespoon of ACV added before meals. But always consult your doctor before making any significant changes to your diet, especially if you have liver disease or take supplements or other medications.

There's a link between insulin resistance and MASLD. This is when your cells become less responsive to insulin, leading to higher blood sugar levels and more fat storage in the liver. Some research shows that ACV may help reduce insulin spikes after meals. We need more studies to know just how well it works. But adding a little ACV to your diet may be another way to manage this major risk factor for fatty liver disease.

Studies have shown that even modest weight loss can reduce liver fat and inflammation, improving liver function. Some studies suggest ACV could help. One small 12-week study showed that people who took 5, 10, or 15 ml of daily acetic acid diluted in water felt fuller longer, so they consumed fewer calories. The study showed it may help boost metabolism and reduce fat storage, which could be particularly helpful for people with fatty liver disease. But we need more research to see if this holds true for all people and for the long term. It's important to remember that the people in these studies were also encouraged to combine ACV with a healthy diet and regular exercise. ACV alone would likely not have had the same results.

Chronic inflammation is a telltale sign of advanced MASLD, so reducing it is important for keeping your liver healthy. Inflammation is a common issue in people with fatty liver disease, and research in mice suggests that apple cider vinegar may help reduce it. Adding ACV to your diet may help lessen the inflammation that comes with fatty liver disease, though more research is needed.

An unhealthy lipid profile, including high levels of bad cholesterol (LDL) and triglycerides, is a risk factor for MASLD and may worsen it if you have it. Limited research suggests that ACV may help improve lipid profiles, including triglyceride and cholesterol levels. By improving lipid levels, ACV may support liver health and slow the progression of fatty liver disease in some people. Using ACV in your diet may help manage lipid levels, along with diet, exercise, and possibly medication. But always talk to your doctor first to see if it's right for you.

You may have seen social media posts claiming that ACV can detox the liver. The word "detox" suggests a cleansing or a flushing out of toxins. That may sound like a cure for a weekend eating binge. But there's no evidence to support such claims. Your liver doesn’t store toxins. In fact, getting rid of them is its job. It rids your body of toxins naturally and without the help of ACV or any other products claiming to detox the liver.

There's also buzz that ACV can boost the immune system. This may be due to the probiotics and antioxidants that ACV contains. Based on research, we know that probiotics work in the gut to strengthen immunity by fighting diseases, allergies, and infections. But the data that links ACV directly to the immune system is lacking. That said, some experts believe apple cider vinegar may indirectly promote immune health by improving gut health.

If you decide to add apple cider vinegar to your daily diet, do it safely. Directly consuming ACV "shots" is not recommended because apple cider vinegar has a lot of acid, which can damage tooth enamel and irritate the digestive tract. Instead, dilute 1 to 2 tablespoons of ACV in a large glass of water and drink it before meals. Starting with a lower dose and gradually increasing to 1 tablespoon in a glass of water may help lessen potential side effects. Always consult with a health care provider to see if it's right for you.

While apple cider vinegar may offer some health benefits, it may not be right for everyone. People with certain conditions, such as chronic kidney disease or digestive issues, should avoid ACV due to its high acid content. Also, people taking any medications, including those for diabetes or heart disease, should consult with a doctor before using ACV, as it can interact with some medications and affect blood sugar and potassium levels. If you have fatty liver disease, it's essential to discuss ACV use with your health care provider to ensure it won't worsen any of your conditions. Understanding potential interactions can help you make informed decisions about adding ACV to your diet.

When taking apple cider vinegar, it's essential to be aware of potential interactions with other foods and medications. ACV can interact with diuretics, insulin, and other medications, potentially leading to adverse effects. And consuming ACV with other highly acidic foods or beverages can increase the risk of gut irritation and tooth enamel erosion. To lessen these risks, always dilute ACV in water and avoid taking it on an empty stomach. Consult your doctor before you add any medications or supplements to your diet.