Apple Cider Vinegar for Gout: Does It Really Work?

Apple cider vinegar has been used as an alternative therapy for decades with claims it can help to lower blood sugar, blood pressure, weight, inflammation, and more. There is minimal research around the health claims of apple cider vinegar—especially related to its effects on gout—but there are a few studies that support some of these claims.

Here, we take a closer look at apple cider vinegar, gout, and health claims related to them.

Bottle of apple cider vinegar next to a basket of apples
 Aniko Hobel/Getty Images

What Is Apple Cider Vinegar?

Apple cider vinegar is created from fermented apple cider. The fermentation process breaks down the natural sugar to produce ethanol, which is then converted to acetic acid by acetic acid bacteria.

Acetic acid, present in both white vinegar and apple cider vinegar, is the component responsible for many of it's health claims. Acetic acid associated with lowering blood sugar levels, aiding in weight loss, and is anti-bacterial.

Apple Cider Vinegar: Nutrition Facts

  • Zero calories because it doesn’t contain carbohydrates, fat, or proteins.
  • Typically, it has 5 to 6% acetic acid depending on its dilution.
  • The only vitamin or mineral in apple cider vinegar is a small amount of potassium.
  • When unfiltered, there is a substance in it called the mother which contains the acetic acid bacteria and enzymes.
  • Apple cider vinegar has a pH of about 2 to 3; anything below a pH of 7 is an acid.

What Is Gout?

Gout is a form of arthritis that causes sudden onsets of pain, swelling, redness, and soreness in the joints. It commonly affects the joints of the big toes, ankles, knees, elbows, wrists, and fingers.

Gout flares occur when high levels of uric acid build up in the body, which triggers inflammation and intense pain in joints. Uric acid is created when purines are metabolized. Purines can be made in the body and are present in foods. Uric acid is then filtered by the kidneys and excreted through urine. 

Diets high in purines have been associated with increased levels of uric acid in the blood. Purines are found in beef, chicken, port, shellfish, and alcoholic beverages.

Apple Cider Vinegar and Gout

It is sometimes claimed that apple cider vinegar is anti-inflammatory and can help reduce inflammation with gout. However, there is no research to support that it has anti-inflammatory effects in humans or that it is effective in preventing gout and gout flares.

One study looked at a diet approach to controlling uric acid levels in the blood and found that following an alkaline diet increased the pH of the urine which was associated with increased excretion of uric acid in urine. The alkaline diet includes lots of fruits and vegetables, whereas the more acidic diet was more protein-rich. Vinegar was included in the alkaline diet, but it was not specified as apple cider vinegar.

A few of the health claims about apple cider vinegar have some supporting evidence and they could indirectly help with gout. Here is a closer look.

Diabetes and Blood Sugar Control

The effects of vinegar for blood sugar control are the most well supported of the health claims. Multiple studies have tested the effects of vinegar on lowering blood glucose levels.

It is suggested that vinegar lowers the glycemic index of foods, which decreases the effect of those foods on your blood sugar level.

A study found that using vinegar salad dressing reduced the blood sugar response to a meal containing 50 grams of carbs by over 30%.

Another study compared the glycemic response to a meal when pickled cucumbers were substituted for a fresh cucumber. The study found the meal with the pickled cucumber resulted in an over 30% reduction in glycemic response to that meal.

If you have diabetes and are taking medication to help lower your blood sugar level, be sure to check with your health care provider before trialing vinegar to manage your blood glucose levels.

Weight Management

A 2017 double-blind research study demonstrated a reduction in body weight, waist circumference, and serum triglyceride levels in the two groups consuming vinegar when compared to the group consuming a placebo. In this study, the groups consuming vinegar were either having 15 ml or 30 ml of vinegar daily. The vinegar in this study was not specified to be apple cider vinegar.

Reduce Inflammation

A study conducted in mice showed that apple cider vinegar helped to control chronic pain and inflammation. The study suggested that its beneficial effects on inflammation could be related to the B-vitamins in apple cider vinegar. While these findings could be promising, there is no evidence that apple cider vinegar is effective in reducing inflammation in humans.

Blood Pressure

A study was conducted in rats testing the effects of apple cider vinegar on blood pressure. The study found that consuming apple cider vinegar daily for six weeks lead to lower systolic blood pressure.

There have been no studies to support this effect in humans.

Despite the lack of evidence for vinegar’s effect on blood pressure in humans, people still claim it lowers blood pressure levels. It is important to remember that there is a strong relationship between weight and blood pressure. A 10% weight loss significantly lowers blood pressure, so it is important to take into account weight and lifestyle changes that are more effective.

Cholesterol Levels

A 2018 randomized control trial found apple cider vinegar helps to reduce triglyceride levels and total cholesterol levels more than a calorie restricted diet alone. This study showed promising preliminary information for apple cider vinegar's effect on cholesterol levels. The study was small with only 39 participants, so more research is needed to demonstrate this effect.

Dosage and Preparation

Apple cider vinegar is available in liquid and tablet forms. There isn’t a standard dose recommended for any of the forms, so follow the directions of the packaging of the products and check with your health care provider before using.

If you are considering adding vinegar to your meals, it seems most studies recommended approximately 15-30ml (1-2 tablespoons) daily. When diluting vinegar, a suggested ratio is a 1:10 vinegar to water ratio. Be aware the amount of acetic acid in apple cider vinegar isn’t standard, whereas white vinegar has a standard 5% acetic acid.

Most of the research for vinegar’s effect on blood sugar and weight used vinegar as a part of the meals as a dressing, topping, or in pickled foods. There was little evidence behind taking apple cider vinegar either in tablet or liquid form outside of meals. Possible ways to consume apple cider vinegar with foods include pickled foods, salad dressing, or as a topping and dip for foods.

Risk and Side Effects

If not properly diluted, apple cider vinegar can be very harmful to your health. Because it is an acid, it can erode and damage tissues if used incorrectly. When used topically, put directly on the skin, it can cause chemical burns if not diluted.

When used internally apple cider vinegar can cause:

  • Esophagitis, throat pain, and difficulty swallowing
  • Damaged teeth enamel and increased cavities
  • Damaged stomach lining
  • Hypoglycemia, especially in individuals taking medication to lower blood sugar levels

A Word From Verywell

Claims of the benefits of apple cider vinegar have been made for centuries. There is some evidence that including vinegar as a part of your diet could help with weight loss and blood sugar control, but it won’t help directly with gout.

Check with your health care provider before using alternative therapies like apple cider vinegar to help manage a condition to discuss the potential side effects on your health and other medications. 

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