What Happens to Your Liver When You Take Apple Cider Vinegar

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

Apple cider vinegar is thought by some to offer numerous health benefits. Among them, ACV may reduce the risk of metabolic dysfunction-associated steatotic liver disease, which was previously called 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 strongly linked to an imbalance in “good” and “bad” bacteria in the gastrointestinal tract (known as gut dysbiosis)

An imbalance can cause the overgrowth of bacteria that release toxins into the bloodstream, which are then filtered by the liver, causing liver inflammation. The same bacteria can affect how lipids (blood fats) are broken down by the liver. Both of these factors can contribute to fat accumulation and the onset of MASLD.

Some animal studies suggest that certain compounds in ACV, such as acetic acid and polyphenols, may improve lipid metabolism and reduce liver fat.

Improved Insulin Sensitivity

Insulin resistance occurs when the body doesn’t respond well to the hormone insulin, hampering glucose (blood sugar) from entering cells for energy. It can also affect the function of the liver, which serves as the reservoir for glucose, impairing the way 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.

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.