Is Apple Cider Vinegar Good for Fatty Liver? The Evidence

TL;DR

• No trial has shown that apple cider vinegar reduces liver fat, inflammation or scarring in people with fatty liver.
• Small studies suggest it may slightly lower fasting blood sugar and body weight, but the trials are short, and the most-shared recent one was retracted in 2025.
• Use it where it clearly helps: as a near-zero-calorie flavor in dressings and marinades. Skip shots, gummies and “liver cleanse” mixes.

Apple cider vinegar isn’t a treatment for fatty liver. No study has shown it reduces liver fat in people with MASLD (formerly NAFLD), and neither the US nor the European liver guideline recommends it. It’s still a useful kitchen ingredient, because a splash adds big flavor for almost no calories.

Here’s what the research does and doesn’t show, the side effects worth knowing, and how to use it sensibly.

Does Apple Cider Vinegar Help Fatty Liver?

Not in any proven way. We could not find a published randomized trial that tested apple cider vinegar in people with MASLD and measured liver fat, liver enzymes or fibrosis. The studies people cite for “liver benefits” are mostly in rats and mice fed high-fat diets, which often don’t translate to humans.

Liver guidelines point in a different direction. The 2024 European guideline (EASL–EASD–EASO) says food supplements and herbal products “cannot be recommended” for MASLD because there isn’t enough evidence that they work. What it does recommend is weight loss, a diet similar to the Mediterranean pattern, avoiding sugary drinks and discouraging alcohol, which should be stopped completely with advanced fibrosis or cirrhosis.

What Do the Vinegar Studies Actually Show?

The human research is about weight and blood sugar, not the liver directly. Here’s the honest picture.

• Blood sugar and cholesterol. A 2021 meta-analysis of nine trials found apple cider vinegar lowered fasting glucose by about 8 mg/dL, HbA1c by about 0.5 points and total cholesterol by about 6 mg/dL. It had no significant effect on LDL cholesterol, fasting insulin or insulin resistance (HOMA-IR).
• Body weight. In a 12-week double-blind Japanese trial, adults with obesity drank a beverage containing 15 or 30 mL of vinegar a day, or a placebo. Body weight, waist size, visceral fat and triglycerides were significantly lower in both vinegar groups than in the placebo group. The researchers worked for a vinegar company.
• The pooled weight data. A 2025 meta-analysis of 10 trials with 789 adults found apple cider vinegar reduced body weight, BMI and waist size. The trials were small and short, lasting 4 to 12 weeks.

There’s an important caveat. The best-known recent trial, a 2024 study of 120 young people in Lebanon that reported significant drops in weight and blood sugar, was retracted in September 2025. The 2025 meta-analysis above still included it in its pooled results. That doesn’t mean vinegar does nothing, but it does mean the weight-loss headlines are shakier than they look.

Why does this matter for your liver? Weight loss is the main lifestyle treatment for fatty liver. The European guideline aims for a sustained loss of at least 5% of body weight to reduce liver fat, 7–10% to improve inflammation, and 10% or more to improve fibrosis. Any effect from vinegar would be a small nudge toward those goals, not a substitute for them. For the changes that move the needle, see how to reverse fatty liver.

What’s in a Tablespoon of Apple Cider Vinegar?

Almost nothing, calorie-wise, which is exactly why it’s useful in cooking. Here’s how it compares with other things you might put on a salad:

Per 1 tablespoon	Calories	Sugar	Saturated fat	Sodium
Apple cider vinegar	3	0.1 g	0 g	1 mg
Balsamic vinegar	14	2.4 g	0 g	4 mg
Ranch dressing, regular	65	0.7 g	1.0 g	135 mg
Honey mustard dressing, regular	70	2.4 g	0.8 g	77 mg
Olive oil	119	0 g	1.9 g	0 mg

Source: USDA FoodData Central (SR Legacy), calculated from per-100 g values using USDA tablespoon weights.

A vinaigrette made with vinegar and a measured amount of olive oil is a better everyday choice than creamy or sweet bottled dressings, mainly because it skips the sodium and added sugar and uses an unsaturated fat. Olive oil is the main fat in the Mediterranean-style eating pattern that liver guidelines point to; see is olive oil good for fatty liver.

Are There Side Effects?

As a salad dressing, apple cider vinegar is very safe. Drinking it every day in larger amounts, or taking it as pills, is where problems show up.

• Teeth. Vinegar is acidic and can wear enamel. The American Dental Association suggests using a straw for acidic drinks, rinsing with plain water afterward and waiting an hour before brushing.
• Throat. A 2005 report in the Journal of the American Dietetic Association described a burn to the esophagus (the food pipe) in a person using apple cider vinegar tablets. When the researchers tested eight tablet products, they found wide differences in acid content and label claims, and doubted whether some contained cider vinegar at all.
• Slower stomach emptying. In a small study of 10 people with type 1 diabetes and gastroparesis, 30 mL of apple cider vinegar with a meal slowed stomach emptying even further, which the authors warned could make blood sugar harder to control.
• Low potassium. A published case report described low potassium and bone loss in a patient who drank large amounts of cider vinegar.
• Medicines. Because vinegar may lower blood sugar slightly, check with your doctor if you take insulin or other diabetes medicines. Ask too if you take medicines that affect potassium, such as some diuretics.

If you have cirrhosis, follow your care team’s plan for fluids, sodium and supplements rather than adding vinegar drinks on your own.

Is Apple Cider Vinegar With Lemon Water a Good Liver Cleanse?

No. Mixing apple cider vinegar with lemon, cayenne or honey is a popular “liver detox,” but there’s no evidence that any drink cleanses the liver. It does double the acid hitting your teeth. And honey adds sugar: about 17 g per tablespoon. The detox idea is covered in more detail in is lemon water good for fatty liver.

How to Use Apple Cider Vinegar With Fatty Liver

The best way to use vinegar is as food, not medicine.

• Make a simple vinaigrette. Whisk 1 tablespoon of apple cider vinegar with 1–2 teaspoons of olive oil, a little mustard and herbs. That’s enough for a large salad.
• Swap it for creamy dressings. A tablespoon of ranch has 65 calories and 135 mg of sodium; a tablespoon of cider vinegar has 3 calories and 1 mg of sodium.
• Use it in marinades for chicken or fish, to brighten roasted vegetables, or in a quick pickle of cucumbers and onions.
• Add it to beans and lentil soups. A splash at the end adds brightness without salt.
• If you drink it, dilute about a tablespoon in a large glass of water, have it with a meal, and don’t sip it all day. Never drink it straight.
• Skip gummies and pills. You don’t know exactly what’s in them, and there’s no evidence they help the liver.

If you’re curious how a vinegar-dressed salad compares with your usual lunch, an app like Liverly can score both from a photo.

Vinegar works best inside a bigger plan built around vegetables, legumes, whole grains, fish and olive oil. Our fatty liver diet guide lays that out, and unsweetened drinks like green tea fit right in.

The Bottom Line

Apple cider vinegar is not a treatment for fatty liver. No trial has shown it reduces liver fat, inflammation or scarring in people with MASLD. Small, short studies suggest slight drops in fasting blood sugar and body weight, but the evidence is thin, and the most-publicized recent trial was retracted.

Where vinegar clearly helps is the kitchen. As a near-zero-calorie flavor in dressings and marinades, it makes it easier to eat more vegetables and skip creamy, salty, sweet dressings. Use it that way, skip the shots and gummies, and talk to your doctor before adding a daily vinegar drink, especially if you have diabetes or take medicines that affect blood sugar or potassium.

Sources

• EASL–EASD–EASO Clinical Practice Guidelines on the management of MASLD: Executive Summary (2024)
• Hadi et al. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials (BMC Complementary Medicine and Therapies, 2021)
• Castagna et al. Effect of apple cider vinegar intake on body composition in humans with type 2 diabetes and/or overweight: a systematic review and meta-analysis (Nutrients, 2025)
• Abou-Khalil et al. Apple cider vinegar for weight management in Lebanese adolescents and young adults (BMJ Nutrition, Prevention & Health, 2024; retracted 2025)
• Hlebowicz et al. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study (BMC Gastroenterology, 2007)

This article is for informational purposes only and is not medical advice. Talk to your doctor or hepatologist about your specific situation.