How to Drink Apple Cider Vinegar: Dose & Timing

|Damian Rayne
How to Drink Apple Cider Vinegar: Dose & Timing

TL;DR

  • Dilute it in a large glass of water, take it with food, and use a straw. Never neat.
  • Cleveland Clinic suggests starting with a few drops in water and going no higher than two tablespoons a day. Most trials used single servings of 10 g (2 teaspoons) to 30 ml (2 tablespoons), and the one 12-week trial split 15 ml or 30 ml a day across two drinks.
  • Most trials gave it with a meal, one at bedtime. Nobody has tested the morning routine for the reasons people follow it.
  • Vinegar wears tooth enamel: in an eight-week trial, twice-daily vinegar drinks raised erosion scores by 18%. Use a straw, and leave an hour before brushing.
  • Ask a GP or pharmacist first if you take insulin, other diabetes medicines, diuretics, laxatives, digoxin or medicines for high blood pressure, and avoid vinegar altogether if your potassium is already low (Cleveland Clinic).
  • This article is general information about published research on vinegar. It is not medical advice, and it does not describe what any drink sold on this site does.

Dilute it, take it with food, and look after your teeth afterwards. That is how to drink apple cider vinegar, and it is roughly where the settled advice ends and the questions begin: how much, when, and what the stuff is doing in the first place. The answers are more modest than the internet suggests, and in places they do not exist at all. Weight is a separate question with its own evidence, covered on our page about apple cider vinegar and weight loss.

This article is general information about published research on vinegar. It is not medical advice, and it does not describe what any drink sold on this site does. There is no authorised health claim in Great Britain for vinegar, apple cider vinegar or acetic acid. If you have a medical condition or take any medicine, speak to a GP or pharmacist before changing your diet.

How do you drink apple cider vinegar?

Vinegar is an acid, and the method follows from that. Diluted and taken with food it is a sharp drink; neat it is an acid bath for your teeth and throat, which is what Cleveland Clinic and Patient.info, a GP-reviewed site, both warn against.

  1. Measure it. Cleveland Clinic advises starting with "just a few drops mixed in water" and working up to "no more than two tablespoons per day". Most trials used single servings of 10 g to 30 ml, and the 12-week trial split its daily amount across two drinks.
  2. Dilute it. A tablespoon in a mug of warm water is Cleveland Clinic's suggestion; a tall glass of cold water does the same job.
  3. Take it with a meal, which is when most trials gave it and where the Oral Health Foundation says acidic drinks belong.
  4. Use a straw, and swallow rather than swill. Both come from the Oral Health Foundation.
  5. Wait an hour before brushing. Acid softens enamel, so give it time to recover.
  6. Finish with milk or cheese, which the Oral Health Foundation suggests to help neutralise acid.
  7. Stop if it makes you feel unwell. Nausea, reflux and an upset stomach are the usual complaints.

What is apple cider vinegar?

Apples are pressed for juice, yeasts turn the sugar into alcohol, and acetic acid bacteria turn the alcohol into acetic acid. That acid is what makes vinegar sour and what makes it strong. Cider and wine vinegars run at about 5% to 6% acetic acid (Johnston and Gaas, 2006), so most of what you pour is water.

How much apple cider vinegar should you drink a day?

No official dose exists, and the reference works say so rather than inventing one. RxList states there is not enough evidence to set a range at all, and Cleveland Clinic's answer is the ceiling quoted above, two tablespoons a day, starting far below it. Treat that as a maximum rather than a target: the one study here that measured damage to teeth used twice as much.

What the research used is easier to pin down:

Study Who took part Vinegar dose Taken with When How long What it measured
Johnston, Kim and Buller, 2004, Diabetes Care 29 adults: 8 insulin sensitive, 11 insulin resistant, 10 with type 2 diabetes 20 g apple cider vinegar 40 g water and 1 tsp saccharine 2 minutes before a bagel, butter and orange juice meal (87 g carbohydrate) One test meal Insulin sensitivity over the hour after eating
Östman and colleagues, 2005, Eur J Clin Nutr 12 healthy volunteers 18, 23 or 28 mmol acetic acid White wheat bread providing 50 g of carbohydrate With breakfast One test meal per dose Glucose and insulin over 2 hours, and fullness
Johnston and colleagues, 2010, Ann Nutr Metab 4 crossover trials, 9 to 10 adults each 10 g (two teaspoons) or 20 g A bagel and juice meal, or a dextrose drink With the meal, or 5 hours before it One test meal per arm Glucose over the 2 hours after eating
White and Johnston, 2007, Diabetes Care 11 adults with type 2 diabetes, aged 40 to 72 2 tablespoons About 28 g (1 oz) of cheese At bedtime 2-day arms, crossover Fasting glucose the next morning
Kondo and colleagues, 2009, Biosci Biotechnol Biochem 175 adults randomised in Japan, 155 completed 15 ml or 30 ml a day 500 ml of drink, split in two After breakfast and after supper 12 weeks Body composition, plus liver and kidney safety measures
Hlebowicz and colleagues, 2007, BMC Gastroenterol 10 patients with type 1 diabetes and gastroparesis 30 ml apple cider vinegar 200 ml water Before breakfast 2 weeks Rate of stomach emptying

Doses appear as each paper published them, which is why some are in grams and Östman's in millimoles of acetic acid, and Kondo's daily totals were split across two drinks. Most of these trials recruited people with type 2 diabetes, insulin resistance or a complication of diabetes. None tested vinegar as a treatment for anything, and nothing on this page is about managing a condition.

When is the best time to drink apple cider vinegar?

With a meal, if you go by the evidence. Johnston and colleagues (2010) put the question directly, giving two teaspoons with the meal in one arm and five hours beforehand in another; the effect on blood sugar was clearer when it came with the food. The other trials line up behind that, from Östman's bread breakfast to Kondo's split between breakfast and supper. There is more on them on our page about apple cider vinegar after meals.

You will see "10 to 15 minutes before eating" repeated everywhere. No trial on this page tested that interval.

One study moved it away from mealtimes and still paired it with food: White and Johnston (2007) gave eleven adults two tablespoons at bedtime with a piece of cheese.

The morning ritual is the awkward one. Hlebowicz and colleagues (2007) did give vinegar before breakfast, but they were studying ten patients whose stomachs emptied too slowly, and emptying was what they measured. Nobody has tested it first thing on waking. If mornings are the only time you will remember, nothing in the evidence rules it out, and nothing measures what it does.

Can you drink apple cider vinegar every day?

For up to twelve weeks, yes, going by the only trial that ran long enough to say. Kondo and colleagues (2009) gave 175 adults in Japan a daily 500 ml drink containing 15 ml of vinegar, 30 ml or none, split between breakfast and supper. A hundred and fifty-five finished, and the researchers reported no adverse effects and no change to liver or kidney function.

Anyone who got heartburn from vinegar was screened out before it began, so the group was not a cross-section of the public, and twelve weeks is as far as the evidence goes.

The harms below turn up at ordinary amounts as well as extreme ones. Keep a daily habit small, inside the two-tablespoon ceiling, and leave it there.

What does drinking apple cider vinegar do?

Nearly all the human research asks one narrow question: what happens to blood sugar and insulin in the two hours after a meal. The measure is area under the curve, a way of totting up how far blood sugar rises after eating and how long it stays up. Shishehbor and colleagues (2017) pooled the trials that had measured it and found a modest reduction in both the glucose and insulin response.

Pooled result, Shishehbor and colleagues (2017) Effect size 95% confidence interval p
Glucose area under the curve −0.60 −1.08 to −0.11 0.01
Insulin area under the curve −1.30 −1.98 to −0.62 <0.001

Effect size here is a standardised mean difference: a measure of how big a change is against the spread of the data, not an amount of anything.

The post-meal trials are small and short. The largest tested 29 people, several fewer than a dozen, and none followed anyone long enough to see whether it changed their health. Liatis and colleagues (2010) added a wrinkle: vinegar changed the response to a high-GI meal and did nothing to a low-GI one.

Two of the claims that circulate most widely are not supported at all. Darzi and colleagues (2014) tested vinegar as an appetite suppressant and concluded that "the promotion of vinegar as a natural appetite suppressant does not seem appropriate", because the drop in appetite they measured arrived with a rise in nausea. And a 2024 trial reporting significant weight loss was retracted by the BMJ Group in 2025 over concerns about the quality of the work.

What are the side effects of apple cider vinegar?

The harms that have actually been documented come from acid, plus one that comes from drinking a great deal of vinegar for years.

Study Who What they took What was found
Anderson and colleagues, 2021, J Med Food Adults in an 8-week randomised trial 2 tbsp in a cup of water, twice daily at mealtimes Erosive wear scores rose 18%; no change in the control group (p = 0.038)
Gambon and colleagues, 2012, Ned Tijdschr Tandheelkd One 15-year-old girl A daily glass of apple cider vinegar Erosive tooth wear diagnosed and traced to the habit
Willershausen and colleagues, 2014, Clin Lab Human enamel samples, laboratory 5 vinegar varieties, up to 8 hours Minerals released from the enamel; authors caution against reading lab conditions across to a real mouth
Johnston and colleagues, 2008, J Med Food Adults with type 2 diabetes Vinegar as a liquid or a pill, 6 weeks 50% to 56% reported at least one side effect, against 11% on the comparison treatment
Lhotta and colleagues, 1998, Nephron One 28-year-old woman About 250 ml of vinegar a day for 6 years Potassium 2.8 to 3.2 mval/l, severely low
Hlebowicz and colleagues, 2007, BMC Gastroenterol 10 patients with type 1 diabetes and gastroparesis 30 ml in 200 ml of water before breakfast, 2 weeks Stomach emptying slowed further, from a median 27% to 17% (p < 0.05)

Does apple cider vinegar damage your teeth?

It can, and this is the best-evidenced risk here: eight weeks of twice-daily vinegar drinks moved a standard erosion score, and a case report traced diagnosed erosion in a teenage girl to a daily glass of it. In the laboratory it strips minerals out of enamel, though the researchers warn against reading that across to a real mouth.

None of which makes vinegar unusual. The Oral Health Foundation lists it with fizzy drinks and fruit juice, and gives one set of advice for all of them: mealtimes, a straw, an hour before brushing.

Can it irritate your throat or stomach?

Yes, and undiluted vinegar is how it usually happens. Cleveland Clinic warns that neat apple cider vinegar can burn the oesophagus, Mayo Clinic that it may irritate your throat if you drink it often or in large amounts, and Patient.info adds an upset stomach and heartburn. Nor is that rare: in one six-week study, about half the people taking vinegar reported at least one side effect, against one in nine on the comparison treatment.

Are apple cider vinegar tablets and gummies safe?

Tablets carry a problem of their own. Hill and colleagues (2005) tested eight brands after an adverse event was reported to them and found they varied considerably in size, acidity, acid content and label claims. Mayo Clinic notes that a tablet which lodges in the throat can cause lasting pain. Diluted liquid is the format the trials used.

Does it affect potassium and medicines?

Large amounts can lower potassium, which is where the interaction warnings come from. The case everyone cites involved about 250 ml a day for six years, a long way from a teaspoon in a glass of water, but the advice that follows is worth taking. Mayo Clinic and Cleveland Clinic both list interactions with insulin and diuretics. Cleveland Clinic adds laxatives and some medicines for high blood pressure, and says to avoid vinegar entirely if your potassium is low. RxList notes that low potassium raises the risk of side effects from digoxin.

Does it slow the stomach?

It can, and in one group that mattered. Ten patients whose stomachs already emptied too slowly drank vinegar in water before breakfast for a fortnight, and their stomachs emptied more slowly still. The researchers treated that as a drawback rather than something to aim for.

Talk to a GP or pharmacist before starting a daily vinegar habit if:

  • you take insulin, other diabetes medicines, diuretics, laxatives, digoxin or medicines for high blood pressure;
  • your potassium is already low;
  • you have a stomach or oesophagus condition, or ongoing reflux;
  • you are pregnant, or giving it to a child.

More in apple cider vinegar side effects.

How can you make apple cider vinegar taste better?

Most of the fix is dilution, and the rest is temperature: vinegar tastes sharper warm and concentrated, so a bigger glass and plenty of ice do more than anything clever.

  • Put the same measure in 300 ml of water rather than 150 ml.
  • Add plenty of ice. Sparkling water dilutes as well as still does, though fizzy drinks are on the Oral Health Foundation's acid list too, so the straw and the wait before brushing matter more.
  • Use a straw, which keeps the acid off your teeth and past your tongue.
  • Cook with it instead. Patient.info suggests vinegar can be "added to a salad dressing, instead of being consumed on its own", which spreads one tablespoon across a whole meal.

Ready-made sparkling versions are the other route: ours are Activate, lemon and mint; Defence, organic ginger; and Metabolism, cinnamon, clove and vanilla. For mixing your own, see apple cider vinegar drinks and an apple cider vinegar drink that tastes good. For the bottles in your cupboard, apple cider vinegar vs white vinegar.

Common questions

Should you drink apple cider vinegar on an empty stomach?

There is no trial either way: the one study that gave vinegar before breakfast was measuring stomach emptying. Vinegar is acidic and may cause an upset stomach (Patient.info), so food is the more comfortable default. There is more on timing on our page about drinking apple cider vinegar in the morning.

Can you drink apple cider vinegar at night?

Yes. One small trial gave two tablespoons at bedtime with a piece of cheese (White and Johnston, 2007). Dilute it as usual and leave an hour before brushing. If lying down after an acidic drink gives you reflux, stop, and see a GP if it continues.

Can drinking apple cider vinegar cause diarrhoea?

No trial on this page reports diarrhoea by name, though one recorded changes in bowel movements (Johnston and colleagues, 2008). Past that the reports are anecdotal; what is documented is an upset stomach, heartburn and nausea. If it happens, dilute more, take it with food, cut the amount, and see a GP if it continues.

What is "the mother", and do you need it?

The mother is the cloudy strand that forms during a slower fermentation: yeast and acetic acid bacteria, which Johnston and Gaas (2006) describe as a nontoxic slime. Most manufacturers filter and pasteurise their vinegar to stop it forming. The same review notes that people keep it for numerous but unsubstantiated health effects, which is a fair summary of the evidence.

About ApealWörld. ApealWörld makes organic sparkling soft drinks in cans, made with 4.5% organic apple cider vinegar and botanicals. There are three: Activate (lemon and mint), Defence (organic ginger) and Metabolism (cinnamon, clove and vanilla), plus a Starter Pack with all three. Each can lists sugars at less than 0.1 g per 100 ml (labelled zero sugar) and 5.2 g of carbohydrate per 100 ml, with no artificial sweeteners and no artificial preservatives. The drinks are pasteurised and are not sold as a source of live cultures. The range is certified organic by the Soil Association and holds a Great Taste 2024 award. If you would rather not measure and mix, the cans are ready to drink. Shop the range, or read more on the Learn about ACV page.

Sources

Some sources below are titled for weight loss. They are cited here only for the dose, timing or safety statements quoted in the text. This page makes no weight-loss claim and does not report those studies' weight outcomes.

  1. Johnston CS, Gaas CA. "Vinegar: Medicinal Uses and Antiglycemic Effect." MedGenMed. 2006;8(2):61. https://pmc.ncbi.nlm.nih.gov/articles/PMC1785201/
  2. Johnston CS, Kim CM, Buller AJ. "Vinegar Improves Insulin Sensitivity to a High-Carbohydrate Meal in Subjects With Insulin Resistance or Type 2 Diabetes." Diabetes Care. 2004;27(1):281–282. https://diabetesjournals.org/care/article/27/1/281/26582/Vinegar-Improves-Insulin-Sensitivity-to-a-High
  3. Östman E, Granfeldt Y, Persson L, Björck I. "Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects." European Journal of Clinical Nutrition. 2005;59(9):983–988. https://www.nature.com/articles/1602197
  4. Johnston CS, Steplewska I, Long CA, Harris LN, Ryals RH. "Examination of the Antiglycemic Properties of Vinegar in Healthy Adults." Annals of Nutrition and Metabolism. 2010;56(1):74–79. https://karger.com/anm/article-abstract/56/1/74/40516
  5. White AM, Johnston CS. "Vinegar Ingestion at Bedtime Moderates Waking Glucose Concentrations in Adults With Well-Controlled Type 2 Diabetes." Diabetes Care. 2007;30(11):2814–2815. https://diabetesjournals.org/care/article/30/11/2814/4824/Vinegar-Ingestion-at-Bedtime-Moderates-Waking
  6. Kondo T, Kishi M, Fushimi T, Ugajin S, Kaga T. "Vinegar Intake Reduces Body Weight, Body Fat Mass, and Serum Triglyceride Levels in Obese Japanese Subjects." Bioscience, Biotechnology, and Biochemistry. 2009;73(8):1837–1843. https://www.jstage.jst.go.jp/article/bbb/73/8/73_90231/_pdf
  7. Liatis S, Grammatikou S, Poulia KA, et al. "Vinegar reduces postprandial hyperglycaemia in patients with type II diabetes when added to a high, but not to a low, glycaemic index meal." European Journal of Clinical Nutrition. 2010;64(7):727–732. https://www.nature.com/articles/ejcn201089
  8. Shishehbor F, Mansoori A, Shirani F. "Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials." Diabetes Research and Clinical Practice. 2017;127:1–9. https://pubmed.ncbi.nlm.nih.gov/28292654/
  9. Darzi J, Frost GS, Montaser R, Yap J, Robertson MD. "Influence of the tolerability of vinegar as an oral source of short-chain fatty acids on appetite control and food intake." International Journal of Obesity. 2014;38(5):675–681. https://www.nature.com/articles/ijo2013157
  10. Anderson S, Gonzalez LA, Jasbi P, Johnston CS. "Evidence That Daily Vinegar Ingestion May Contribute to Erosive Tooth Wear in Adults." Journal of Medicinal Food. 2021;24(8):894–896. https://doi.org/10.1089/jmf.2020.0108
  11. Gambon DL, Brand HS, Veerman EC. "Unhealthy weight loss. Erosion by apple cider vinegar." Nederlands Tijdschrift voor Tandheelkunde. 2012;119(12):589–591. https://europepmc.org/article/MED/23373303
  12. Willershausen I, Weyer V, Schulte D, Lampe F, Buhre S, Willershausen B. "In vitro study on dental erosion caused by different vinegar varieties using an electron microprobe." Clinical Laboratory. 2014;60(5):783–790. https://europepmc.org/article/MED/24839821
  13. Hill LL, Woodruff LH, Foote JC, Barreto-Alcoba M. "Esophageal Injury by Apple Cider Vinegar Tablets and Subsequent Evaluation of Products." Journal of the American Dietetic Association. 2005;105(7):1141–1144. https://europepmc.org/article/MED/15983536
  14. Lhotta K, Höfle G, Gasser R, Finkenstedt G. "Hypokalemia, Hyperreninemia and Osteoporosis in a Patient Ingesting Large Amounts of Cider Vinegar." Nephron. 1998;80(2):242–243. https://karger.com/nef/article-abstract/80/2/242/209061/Hypokalemia-Hyperreninemia-and-Osteoporosis-in-a
  15. Hlebowicz J, Darwiche G, Björgell O, Almér LO. "Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study." BMC Gastroenterology. 2007;7:46. https://pmc.ncbi.nlm.nih.gov/articles/PMC2245945/
  16. Johnston CS, et al. "A preliminary evaluation of the safety and tolerance of medicinally ingested vinegar in individuals with type 2 diabetes." Journal of Medicinal Food. 2008;11(1):179–183. https://pubmed.ncbi.nlm.nih.gov/18361754/
  17. Oral Health Foundation. "Dental erosion." https://www.dentalhealth.org/dental-erosion
  18. Cleveland Clinic. "What Apple Cider Vinegar Can (and Can't) Do for You." https://health.clevelandclinic.org/exploring-the-health-benefits-of-apple-cider-vinegar
  19. Mayo Clinic. "Apple cider vinegar for weight loss." https://www.mayoclinic.org/healthy-lifestyle/weight-loss/expert-answers/apple-cider-vinegar-for-weight-loss/faq-20058394
  20. RxList. "Apple Cider Vinegar." https://www.rxlist.com/supplements/apple_cider_vinegar.htm
  21. Patient.info. "Does apple cider vinegar help with weight loss?" GP-reviewed; last updated 21/10/2025. https://patient.info/features/healthy-living/apple-cider-vinegar-does-it-help-with-weight-loss
  22. Great Britain Nutrition and Health Claims (NHC) register, gov.uk. Updated 19/05/2026. https://www.gov.uk/government/publications/great-britain-nutrition-and-health-claims-nhc-register
  23. NPR. "A study that claimed apple cider vinegar helps with weight loss has been retracted." 05/10/2025. https://www.npr.org/2025/10/05/nx-s1-5562526/apple-cider-vinegar-study-retracted-weight-loss