Most studies on apple cider vinegar (ACV) use between 1 and 2 tablespoons (15 to 30 mL) per day, diluted in water. There’s no official dosage recommendation, but the amount that works best depends on what you’re hoping to get out of it.
Dosages Used in Studies
Research has tested a range of doses for different health goals, and the amounts vary enough that it’s worth matching your intake to what’s actually been studied.
For blood sugar control, 2 tablespoons taken right before a meal is the most commonly studied dose. Drinking it immediately before eating, especially a carb-heavy meal, appears to help reduce blood sugar spikes. For cholesterol improvements, about 1.5 tablespoons after a meal showed benefits in one study.
For weight management, a 2024 study published in BMJ Nutrition tested three doses: 5, 10, and 15 mL daily (roughly 1 teaspoon, 2 teaspoons, and 1 tablespoon). After 12 weeks, participants with overweight or obesity lost between 6 and 8 kilograms (about 13 to 17 pounds). The group taking the highest dose, 1 tablespoon, saw the greatest reduction in body weight and BMI. Earlier Japanese research found similar results with 1 to 2 tablespoons daily over the same timeframe.
For acid reflux, a much smaller amount is typical: 1 to 2 teaspoons stirred into a mug of warm water after a meal.
If you’re just starting out, 1 tablespoon per day is a reasonable middle ground. You can increase to 2 tablespoons if you tolerate it well.
How to Dilute It Safely
Apple cider vinegar is roughly 5% to 6% acetic acid, which is strong enough to irritate your throat, stomach lining, and tooth enamel if you drink it straight. Always dilute it. A good ratio is 1 tablespoon of ACV in at least 7 ounces (about 200 mL) of water, which is a little less than a standard cup. Some people add it to a full glass of water, which works fine and makes it easier to drink.
To protect your teeth, the American Dental Association recommends drinking the mixture through a straw, swishing plain water in your mouth afterward, and waiting at least an hour before brushing. Brushing too soon on acid-softened enamel can do more damage than the acid itself.
Pills vs. Liquid
ACV capsules are an option if you can’t stand the taste. A typical capsule contains about 500 mg, roughly equivalent to 2 teaspoons of liquid vinegar. The main advantage of capsules is that they skip the acid exposure to your teeth and throat entirely.
The downside is consistency. Because ACV supplements aren’t regulated by the FDA, what’s on the label doesn’t always match what’s inside. One analysis of eight different ACV pill brands found that the ingredients and dosages listed were inconsistent and sometimes inaccurate. If you go the capsule route, stick to brands that provide third-party testing. It’s also unclear whether the pills deliver the same effects as the liquid form.
Side Effects of Taking Too Much
At normal doses of 1 to 2 tablespoons per day, most people tolerate ACV without problems. Higher amounts can cause nausea, bloating, and heartburn. In one study, participants who consumed about 25 grams of ACV reported significantly more nausea alongside reduced appetite, which isn’t exactly a useful tradeoff.
ACV slows the rate at which your stomach empties, which is part of how it blunts blood sugar spikes. But if you already have slow stomach emptying (gastroparesis), this effect can worsen symptoms like bloating and acid reflux.
The most serious documented case involved a woman who drank 8 ounces (1 full cup) of ACV daily for six years. She was hospitalized with dangerously low potassium levels and was diagnosed with osteoporosis at age 28. Her doctors concluded that the chronic acid load was pulling minerals from her bones. This is an extreme example, but it illustrates why sticking to 1 to 2 tablespoons is important, and why more is not better.
Medication Interactions to Watch For
ACV can interfere with several common medications, primarily by affecting blood sugar or potassium levels.
- Diabetes medications: ACV lowers blood sugar on its own. Combined with insulin, metformin, or newer injectable medications like semaglutide or tirzepatide, it could push blood sugar too low.
- Diuretics (water pills): Many diuretics already lower potassium as a side effect. Adding ACV, which can also reduce potassium, increases that risk.
- Blood pressure medications: ACE inhibitors and ARBs affect potassium balance in the opposite direction, raising levels. ACV can complicate this balance unpredictably.
- Heart medications like digoxin: Low potassium caused by ACV can increase the risk of toxicity from digoxin, which is used for heart failure and irregular heart rhythm.
- Stimulant laxatives: Long-term or high-dose use of stimulant laxatives already depletes potassium. Combining them with ACV compounds the problem.
If you take any of these medications, talk to your pharmacist or prescriber before adding ACV to your routine. The interaction risk is dose-dependent, so occasional use is less concerning than daily supplementation.
A Simple Starting Approach
Start with 1 tablespoon diluted in a full glass of water, taken before your largest meal. If your goal is blood sugar management, timing it right before eating matters more than the time of day. If you’re using it for weight management, morning consumption on an empty stomach was the protocol used in the BMJ weight loss study. Give it at least a few days to see how your stomach handles it before increasing to 2 tablespoons. Splitting the dose, 1 tablespoon before lunch and 1 before dinner, can also reduce the chance of digestive discomfort.