People with asthma typically treat the inflammatory condition through a combination of long- and short-term medications. Some may add natural therapies to help calm their symptoms. Apple cider vinegar — or ACV, as it’s often called — is one such remedy with purported benefits for asthma.
ACV is made through the fermentation of apples, and studies do suggest it may help with weight loss, lowering blood pressure (according to a study published in 2016 in the European Journal of Nutrition), and reducing levels of “bad” cholesterol.
But does ACV actually help when it comes to asthma? Here’s what you need to know.
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Can ACV Help Asthma?
Apple cider vinegar has health properties that may be beneficial for people with asthma, but as of yet no high-quality studies have been published that specifically looked at ACV’s effect on asthma symptoms and proved the tonic helps alleviate the symptoms of the chronic breathing condition, explains Maeve O’Connor, MD, the chair of the integrative medicine committee for the American College of Allergy, Asthma, and Immunology and an allergist in private practice in Charlotte, North Carolina.
“There are no double-blind placebo-controlled trials assessing ACV's use in asthma that I am aware of,” Dr. O’Connor says. In testing interventions, randomized double-blind placebo-controlled studies are considered to be the “gold standard,” according to the scientific community.
So for now, theories about how ACV might help people with asthma are still just theories.
One such theory is that ACV lowers inflammation in the lungs and stops the growth of bacteria and viruses. Again, research has not yet looked at whether ACV does in fact help in these ways in people with asthma and whether ACV does in fact help asthma symptoms.
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What we do know is that asthma is characterized by the occasional inflammation and narrowing of the airways in the lungs, which at times can lead to the shortness of breath, wheezing, and chest tightness known as an “asthma attack.” And research shows that bacterial and viral infections can irritate and trigger these symptoms. According to a review article published in the November–December 2014 issue of the Journal of Allergy and Clinical Immunology: In Practice, there is evidence such infections either exacerbate symptoms or may play a role in the development of asthma. A study of 108 children with asthma from a single community found that upper respiratory viral infections were associated with an 80 to 85 percent worsening of asthma symptoms.
And research also does suggest that ACV has anti-inflammatory and antimicrobial properties. For example, research published in January 2018 in Scientific Reports found that ACV not only halted the growth of microbial species like E. coli and S. aureus (a type of germ that can cause staph infections), but it also helped prevent the release of pro-inflammatory cytokines, a type of protein that triggers inflammation. The study authors note that they suspect the anti-inflammatory and antimicrobial properties of ACV are largely due to the organic acetic acid found in vinegar (ACV is typically 5 to 6 percent acetic acid, while white distilled vinegars are generally 4 to 7 percent, according to the National Capital Poison Center), as well as nutrients from the apples themselves. But again, none of this research has looked at how these properties of ACV might affect people with asthma specifically.
Another way ACV might ease asthma symptoms is by reducing esophageal reflux, a condition where the contents of your stomach back up into your esophagus. Esophageal reflux is entirely different from asthma, explains Malcolm B. Taw, MD, the director of the Center for East-West Medicine in Westlake Village and an associate clinical professor in the department of medicine, both at the University of California in Los Angeles. But sometimes asthma symptoms can be worsened by esophageal reflux, Dr. Taw says. “If you have gastric contents that go up, it can irritate your airways,” he explains.
That said, there’s very little evidence to support the role of ACV in esophageal reflux (according to Taw and information from Harvard Medical School), or how this might affect asthma. “From a research standpoint, it’s more anecdotal,” Taw notes.
Here Are Some Risks Associated With Ingesting Too Much ACV
ACV may be “natural,” but that doesn’t mean it’s safe.
Vinegar in general may interact with a variety of medications, including diuretics, laxatives, and medicines for heart disease and diabetes, according to the University of Washington. Check with your doctor or pharmacist if you’re taking these (or any other) medications to find out if there’s any risk of an interaction. Drinking too much vinegar can also cause a decrease in potassium, which can be life-threatening, according to the University of Washington.
Additionally, ACV can cause damage to tooth enamel, irritate the throat, and cause nausea, O’Connor says. A study published in 2014 in the International Journal of Obesity found that taking vinegar with breakfast caused nausea and indigestion for many participants.
The Bottom Line: Approach ACV With Caution
Though ACV has anti-inflammatory and antimicrobial properties that may theoretically be beneficial for people with asthma, there’s reason to be cautious. Because the research on these uses has not yet been done, there also may be unintended and unknown side effects when used in these ways.
In addition, experts have no set safe or recommended amounts of apple cider vinegar for its various health uses, O’Connor says. But drinking no more than 1 to 2 tablespoons per day may be appropriate for most medicinal purposes. The Cleveland Clinic suggests diluting a small amount in a mug of warm water and drinking this before or after a meal.
Also, be aware, as previously mentioned, that ACV may interact with certain medications, decrease potassium levels, damage tooth enamel, irritate the throat, and cause nausea and reflux.
It’s always a good idea to talk with your doctor before trying any alternative or complementary therapies. He or she can help review the risks and potential benefits and make a recommendation specific to you that takes your overall health into account.
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If a patient asked about wanting to try ACV to help with reflux, Taw says he likely wouldn’t have a problem with it for most patients. “Would I recommend it? That’s hard to say,” he adds.