Can Apple Cider Vinegar Help Fatty Liver Disease?

Some early research in mice and small groups of people suggests that apple cider vinegar (ACV) – in moderation – may offer benefits for some people who have metabolic-associated fatty liver disease (MAFLD) and metabolic-associated steatohepatitis (MASH). Moderate use may improve lipid profiles (cholesterol numbers), blood sugar control, and the body’s natural defenses in some people, the studies suggest. Making ACV part of your diet can be as simple as drinking a glass of water with a tablespoon of ACV added before meals. But always consult your health care provider before making any significant changes to your diet, especially if you have liver disease or take supplements or other medications. 

Insulin resistance is a condition where the body's cells become less responsive to insulin, leading to higher blood sugar levels and increased fat storage in the liver. Poor insulin resistance is a risk factor for fatty liver disease. Research in mice appears to show that apple cider vinegar may slightly improve insulin resistance. It may do this by slowing the rate at which sugar enters the bloodstream, reducing the insulin spike after meals. Adding a little ACV to your salad dressing or drinking a tablespoon of it in a glass of water may end up being a simple way to help manage insulin resistance. But more research is needed before that can be recommended.

Studies have shown that even modest weight loss can reduce liver fat and inflammation, improving liver function. There are some studies that suggest apple cider vinegar 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 for 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, as weight loss can significantly improve liver health. But more research is needed to see if this would hold true for all people and for the long term. It is 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 can lead to liver damage and fibrosis, 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 with fatty liver disease, though more research is needed.

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 suitable 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 health care provider before using ACV, as it can interact with some medications and affect blood sugar and potassium levels. For people with fatty liver disease, it's essential to discuss ACV use with a health care provider to ensure it won't worsen any of their 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.