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Apple cider vinegar for PCOS: fact or fad?

Apple cider vinegar is known as a superfood in some health circles. On social media, it is often promoted as being beneficial for PCOS and people are encouraged to take a few tablespoons of apple cider vinegar a day to help with symptoms. But is there any evidence for apple cider vinegar for PCOS? Or is it just another fad? Let’s find out.

What is PCOS?

Polycystic ovary syndrome is an endocrine condition impacting approximately 6-13% of people worldwide according to the World Health Organisation. Symptoms of PCOS include irregular periods, hair loss on the head, excessive hair growth on the face, excess body hair, oily skin, acne and trouble getting pregnant.

Although the condition cannot be cured, PCOS management involves lifestyle changes like nutrition, supplementation, regular exercise and more.

People often turn to home remedies to improve PCOS symptoms such as apple cider vinegar. But are there any health benefits of apple cider vinegar for PCOS, or is it just a TikTok fad?

What is apple cider vinegar?

Apple cider vinegar, often called ACV, is a type of vinegar made from apples. To make apple cider vinegar apples are first crushed to extract their juice, which is then exposed to yeast to ferment the sugars in the juice which converts them into alcohol. A type of bacteria called Acetobacter is added to convert the alcohol into acetic acid. The vinegar is then allowed to age which enhances its flavour and leads to its characteristic pungent smell.

Apple cider vinegar is available in both filtered and unfiltered forms. Unfiltered varieties, often labelled as “with the mother,” contain strands of proteins, enzymes, and bacteria that give the vinegar a cloudy appearance. These “mother” strands are thought to have health benefits and be an active ingredient of ACV, although scientific evidence on this is limited.

Apple cider vinegar is often consumed as a “shot” where someone drinks a tablespoon of apple cider vinegar on an empty stomach or adds it to a glass of water. This is because ACV is considered one of many “natural remedies” for hormonal health, blood sugar issues and more. But are there really any potential health benefits of ACV for PCOS?

Does apple cider vinegar have benefits for PCOS?

Although there are many potential benefits of apple cider vinegar touted across the internet and social media, we must evaluate the evidence to really understand whether apple cider vinegar benefits PCOS symptoms.

There are five main claims that people make regarding ACV as a natural remedy for PCOS: it increases satiety, aids digestion, helps with blood sugar balance, improves blood pressure and restores ovulation. Let’s investigate each of these claims and see whether they are fact or fiction.

Claim #1: may increase satiety

Because of its acetic acid content, apple cider vinegar may increase satiety (i.e. making you feel fuller for longer) which may contribute to weight loss. Here at The PCOS Collective, we know that focusing on weight loss often harms, rather than helps PCOS and we recommend intuitive eating for PCOS instead.

The studies that have shown weight loss from apple cider vinegar consumption are extremely small scale, are short term and resulted in modest weight loss. They also didn’t investigate the impact on people with PCOS.

Lots of kinds of vinegar contain acetic acid, so apple cider vinegar is not “special” in this way. In fact, the nausea-inducing effects of consuming apple cider vinegar because of its pungent smell may actually be the cause of increased satiety and weight loss!

Claim #2: may improve gut health

One of the main claims for the benefits of ACV is that it may improve gut health. This is because apple cider vinegar contains pectin that can feed good gut bacteria to promote a healthy gut. But you can actually get more pectin from an actual apple – so maybe stick to apple slices instead of a vinegar shot!

Claim #3: may lower blood sugar levels

People with PCOS tend to have insulin resistance. In fact, up to 80% of people living with PCOS, no matter their body weight, may have insulin resistance. Managing insulin levels and blood glucose levels is often a key part of PCOS management.

Apple cider vinegar may help with blood sugar control. A 2021 systematic review and meta-analysis of nine studies found that ACV consumption (around 15ml/day) resulted in a reduction of total glucose levels of those with type 2 diabetes mellitus. This study was not conducted on people with PCOS and also found that there was no significant effect on fasting insulin concentrations or HOMA-IR (a model assessment for insulin resistance).

2017 systematic review and meta-analysis found that those who consumed vinegar had lower glucose and insulin levels after eating compared to a control group. This study appears to find that apple cider vinegar may help to lower blood sugar spikes, but more high-quality evidence, particularly in people with PCOS, is required.

Claim #4: improves blood pressure

People with PCOS have a 3x risk of having high blood pressure compared to those living without the syndrome, so trying to lower blood pressure is understandable for people with PCOS. High blood pressure, known as hypertension, can lead to heart disease, stroke and other health conditions.

The current research on apple cider vinegar for blood pressure is on rats and/or looks at acetic acid independently of apple cider vinegar – basically it is extremely low-value research and we need various studies on the actual impact of apple cider vinegar on blood pressure in people living with PCOS before we can make any claims.

Claim #5: may restore ovulation

People with PCOS tend to have irregular ovulation or a complete lack of ovulation. This can make it challenging to become pregnant.

2013 study investigated seven PCOS patients who drank a beverage containing 15g of ACV daily for up to 110 days. This study found that ovulatory function improved in four of seven patients within 40 days. As you’ve probably realised, this study is incredibly small and more high-quality research is required to understand whether apple cider vinegar can improve ovulation in people with PCOS.

Side effects of apple cider vinegar

Although consuming apple cider vinegar does appear to be safe in moderate amounts, there can be some side effects associated with consuming too much acidic vinegar.

The most common side effect of consuming apple cider vinegar is tooth enamel damage. Many people consume apple cider “neat” which can erode tooth enamel leading to dental problems. In order to avoid damage to your teeth consume ACV as part of a meal, rather than shooting it, and rinse your mouth out with water if you do take it neat. Also, avoid brushing your teeth immediately after consuming it.

Apple cider vinegar can lead to gastrointestinal issues because of the harsh nature of the acid. This may lead to nausea, diarrhoea or stomach upsets.

Also, apple cider vinegar may interfere with certain medications such as diuretics or insulin. Always speak to healthcare professionals before trying any new dietary change.

Is apple cider vinegar good for PCOS?

To put it simply, not really. Apple cider vinegar does not have enough evidence behind it to conclusively recommend it for PCOS. It has some promising benefits such as potentially impacting blood glucose levels but more research is required. If you do want to consume apple cider vinegar for its potential blood sugar-balancing benefits, instead of taking it as a shot, use it as a food to prevent tooth enamel damage or nausea symptoms. We believe the best way to consume apple cider vinegar if you enjoy it is to add it to salad dressings and sauces.

How to consume apple cider vinegar

If you do choose to enjoy apple cider vinegar in your diet then how about making a quick and simple salad dressing? Here is the recipe:

Ingredients

3 tablespoons extra-virgin olive oil
1-2 tbsp ACV (approximately 15-30 ml of apple cider vinegar)
1 teaspoon honey or maple syrup
1 teaspoon Dijon mustard
Salt and pepper to taste

Method

  1. Whisk together the vinegar, honey and mustard until well combined.
  2. Slowly stream in the olive oil and continue to whisk to emulsify the dressing.
  3. Add salt and pepper to taste and toss through a salad of your choice.
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Alex Okell ANutr Founder and Editor

Founder and Editor | Registered Associate Nutritionist

  Founder of Be The Collective LTD [The PCOS Collective & The Endo Collective] Alex Okell ANutr is a London-based reproductive health nutritionist with experience in research, private practice and digital media. She holds a Master’s degree in Nutrition from King’s College London and has co-authored papers with the University of Cambridge, King’s College London, The Food Foundation and the Food Standards Agency. Alex offers 1:1 PCOS support in our virtual PCOS clinic.

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