[toc]If you drink it straight, this sour golden liquid will make your lips pucker, no doubt. Yet because of the many health benefits linked to it, that doesn’t seem to dampen the hype for this superfood.
Unlike many other superfoods which are hot today and gone tomorrow, the Bragg brand has been a favorite for over a half a century.
And unlike fad diets, drinking ACV for weight loss has been a mainstay throughout multiple generations.
Mr. Paul Bragg brought it to the masses in his famous book, first published in 1972.
Long after Mr. Bragg passed, a new variant of the diet came to fruition; apple cider vinegar supplements.
We’re talking about the pills, capsules, and tablets which all purport to offer the same benefits of liquid vinegar, except in an easy-to-take form.
Too good to be true? Let’s review the evidence…
ACV capsules vs. liquid
Liquid apple cider vinegar is made by fermenting apples with yeast and bacteria, typically in oak barrels. When this liquid is dehydrated to create a dry powder, it can be used to make tablets and fill capsule supplements.
How much apple cider vinegar supplements should I take?
Raw organic liquid vinegar, like Bragg’s, lists a serving size of 1 tablespoon (15 mL). Some people use this 2-3 times per day to curb their appetite, or for an ailment of some kind. Often digestive related, such as gas and bloating. Some say it helps their gout.
The conversion ratio for ACV capsules to liquid is purported to be anywhere from 1:10 to 1:15. Meaning, a single 500 mg capsule equates to 10-15 mL of liquid vinegar. 15 mL is 1 tablespoon.
The problem is that almost none of the pill manufacturers disclose how many you have to take to get the 1 or 2 tablespoon equivalent.
The brands Natural Factors, Spring Valley, KAL, GNC, NOW, Sundown, Havasu, Super, Potent Organics, Puritan’s Pride, Purely Inspired, Country Farms, and others have directions which say to take 1 to 2 tablets or capsules per day and not to exceed that amount. Each brand is 450-600 mg per pill.
Ultimately, if you’re looking for the right ACV pill dosage for weight loss, acid reflux, or whatever else you currently use the liquid for, finding the right conversion can be near impossible, given the lack of guidance provided by supplement manufacturers.
Are the active ingredients still intact?
Knowing an accurate conversion ratio is important but even more so, the bigger question is whether or not the active compounds in the liquid remain intact (and equally bioavailable) when taken in capsule or tablet form.
The “mother” is found in unfiltered cider vinegar. It’s that cobweb-like cloud you see floating in the bottle, prior to shaking or stirring. It’s the bacteria which was responsible for fermenting the apple cider into vinegar.
A 2016 study out of a university in Slovenia reports that the bacteria in the mother primarily consists of five species; Lactobacillus, Acetobacter, Oenococcus, Komagataeibacter, and Gluconobacter. All of these are considered probiotics, or good bacteria for aiding digestion in the small intestines.
Manufacturers of ACV supplements do not claim or report probiotic content. Most likely the probiotics are dead but the same holds true for the liquid vinegar.
Contrary to what some sources claim, there is no good evidence of it surviving past fermentation. Not even in the raw unfiltered varieties made using USDA certified organic apples. (1)
While even dead probiotics might offer some health benefits, the bioactive constituents in cider vinegar are believed to be:
The main active ingredient, it’s what gives it the sour taste. (2)
It too produces a sour taste. There’s less of it than acetic acid. (2)
This is a fiber which serves as a prebiotic, meaning it serves as food for the probiotics already in your intestines. This is in trace amounts. (3)
The main antioxidant found in coffee. In ACV, the amount is trivial in comparison. (4) (2)
While there are a number of potentially beneficial phytonutrients in apple vinegar, research suggests that acetic acid is responsible for helping to lose weight and other medical advantages. The other compounds are in trace amounts and probably play a minimal role, if any, when it comes to the most touted benefits of ACV pills and liquid vinegar.
Living microorganisms (e.g. probiotics), antioxidants, and vitamins are often sensitive to degradation from exposure to air, light, and heat.
On the other hand, a compound like acetic acid would be expected to keep its potency even with processing – e.g. drying and time elapsed. However research does report that acetic acid degrades rather rapidly with UV light exposure. (5) (6)
That’s why with liquid vinegar, it’s ideal to buy it in an amber glass bottle. As much as we love Bragg, unfortunately they use clear glass. Michigan-based Eden Organics does use amber. You can buy theirs on Amazon and at physical stores which carry the Eden brand.
In short, the main ingredient in cider vinegar should hold up comparatively well, regardless of whether you’re using the classic liquid or dehydrated forms like tablets.
Side effects of ACV pills
Taking dehydrated cider vinegar or acetic acid (the main ingredient) in the form of gelatin or vegan capsules should result in fewer side effects versus drinking the liquid. This is because ACV can cause tooth erosion, irritation of the mouth and throat, and nausea. These side effects may be avoided with tablet or pill forms you swallow. (7) (8)
Chewable tablets are likely even more dangerous than liquid apple cider, because the acetic acid would be more concentrated. That could amplify damage to the teeth, mouth, and throat.
Online customer reviews of Kal ACV chewables are often positive, but we question what long term effects they may be having on dental erosion. They advertise a minimum concentration of 35% acetic acid. Why would you want that undiluted on your teeth?!
Only one side effect of ACV supplements has been reported in published medical literature. It was a case study of a female who experienced throat irritation and difficulty swallowing after a pill got stuck in her throat for 30 minutes. This is not surprising, as those side effects could happen with virtually any supplement you swallow. (9)
With both liquids and pills, adverse reactions once in the stomach and after being digested may include lack of appetite. When used in high amounts daily for weeks or months, low potassium levels may occur. (10)
Studies on ACV capsules and tablets
When it comes to bona fide scientific research which has been peer-reviewed, you can search the nearly 30 million pieces of literature in the PubMed database and you will only find one directly related to this topic.
Human clinical studies reviewing cider vinegar pills for dieting, or any other purpose, have not been published.
Therefore, any manufacturer claims aren’t really based on verifiable hard facts.
The one and only published piece of medical literature was in the Journal of the American Dietetic Association. It was in a 2005 issue.
The piece was a case study on the 48 year old women who had a tablet lodged in her throat for 30 minutes. This resulted in side effects such as pain and difficulty swallowing. In other words, an esophageal injury.
As part of the paper, the doctors purchased 8 unnamed brands of apple cider vinegar pills and tested them for pH levels and content of acetic acid and citric acid.
The results were disturbing…
The percentage of acetic acid ranged from 1-10%. That’s a 10-fold variance!
They said the product labels did not correlate with what was inside the capsules/tablets. The dangers of that are real:
“If acid claimed on the label, they could be considered poisonous, as indicated by the Consumer Product Safety Commission, which states that an “acetic acid preparation containing free or chemically unneutralized acetic acid in concentration of 20% or more shall be deemed a poison”
They also went on to discuss the unproven claims on some of the supplements.
For example, some labels claimed benefits such as blood thinning, detoxifying, cleansing, healing, germ fighting, weight loss, joint pain relief, fighting infections, and aiding digestive difficulties.
With no clinical trials being done, obviously these claims are out of line for supplement manufacturers to be making on their bottles. (11)
In fact, the only clinical study conducted on dried or dehydrated apple cider vinegar involved giving it to white shrimp (Litopenaeus vannamei).
Published in 2017, various experimental diets were given to farmed shrimp. Three of those had dried ACV being included in their feed, in concentrations of 1%, 2%, and 4% of their diet.
When compared to the control diet, those supplemented with ACV experienced “significant upregulation” of genes related to immune system performance. Intriguing but of course, shrimp are not humans, so one cannot extrapolate and say that it helps fight infections, colds, or the flu in humans. (12)
Best ACV pills to buy
Given the published findings of 8 supplement brands containing up to a 10-fold variance in acetic acid content, one should be cautious as to which brands they buy.
Not to say that generic or lesser-known brands are unsafe or dangerous, but given the greater scrutiny which is generally applied to market leaders, it would be a good idea to stick with those for apple cider pills, capsules, and tablets.