Does apple cider vinegar help with inflammation and arthritis?

Nobody knows, because it has not been tested in people. We found no randomized trial of apple cider vinegar that measured an inflammatory marker such as CRP, IL-6 or TNF, and none that measured joint pain in arthritis. The largest meta-analysis of apple cider vinegar, 25 clinical trials with 1,320 adults, pooled only lipid and glucose outcomes, so no inflammatory result has ever been pooled. The one anti-inflammatory finding we found is in rats.

Unsettled. The claim has no human evidence behind it in either direction. A rat study found less paw swelling, and a human trial measured oxidative stress, which is a related but different thing. Neither tells you what a daily spoonful does to a stiff knee.

Paw swelling prevented after 24 hours, in rats

Every bar is from an animal experiment in which swelling was triggered by an injection of carrageenan. The study reports no intervals, so none is drawn. There is no human result to put beside these. Source: card ev-acvin-04 below.

What the trials found

The closest human trial measured something else

In an 8-week trial, 70 adults with type 2 diabetes and high blood lipids were randomly assigned to 1.4 tbsp (20 mL) of apple vinegar a day or to a control group. The vinegar group's antioxidant activity, measured as DPPH, rose by 16.58 units, and fasting glucose fell by 10.16 mg/dL compared with control. Malondialdehyde, a marker of oxidative damage, rose only in the control group. The abstract describes no placebo and no blinding, and the trial did not measure CRP, IL-6 or TNF. Oxidative stress and inflammation overlap, and they are not the same measurement.

The same trial found no considerable effect of the vinegar on blood pressure or on homocysteine, a marker of vascular risk.

The anti-inflammatory result is in rats

In rats whose paws were made to swell with an injection of carrageenan, vinegar from Golden Delicious apples at 10 mL per kg of body weight prevented 37.5 percent of the swelling after 24 hours. The drug diclofenac prevented 58.3 percent. Vinegars from two other apple varieties did less, at 28.3 and 21.67 percent, so even in the animal model the result depended on the apple. A swollen rat paw is a standard laboratory test and it is not arthritis.

Unsettled. Apple cider vinegar for arthritis has never been tested in a trial in people with arthritis. Untested is not the same as disproven, and it is not the same as shown to work.

Who should be careful

Tablets are their own problem. After an adverse event from an apple cider vinegar tablet was reported to researchers, they tested 8 tablet products and found wide differences between brands in tablet size, acidity, acid content and label claims. They could not be sure some of the tablets contained apple cider vinegar at all. That is one case and one set of products, and it is still a reason to doubt that the label tells you the dose.

Vinegar can make people feel sick. In a crossover study of 16 adults, vinegar drunk with breakfast reduced appetite and brought significantly higher nausea ratings, most of all when the drink tasted worst. That was a single dose, so it shows tolerability and says nothing about long-term harm.

Not for everyone. If you take medicine for arthritis or inflammation, apple cider vinegar has not been shown to do any part of that job, and it is no reason to change a dose. If you try it, a diluted liquid is easier to judge than a tablet whose contents vary by brand.

What expert bodies say

We found no position from a health agency or a rheumatology society in our trusted sources on apple cider vinegar for inflammation or arthritis. The pages we did find came from patient charities and health websites outside that list, so they are not cited here.

How we searched

Searched: a local copy of PubMed for vinegar or acetic acid with inflammation, CRP, interleukin, TNF, arthritis and oxidative stress, which returned 68 records with no apple cider vinegar trial among them. Europe PMC searches found 7 meta-analyses of vinegar, none on inflammation, 124 records on vinegar and inflammation that were animal, laboratory or narrative work, and 112 records on apple cider vinegar with inflammatory or oxidative markers, of which three were human trials. We also searched the retraction database and the open web. Search run on 7 October 2026.

Included: the largest apple cider vinegar meta-analysis, to show what it covered, one randomized trial in adults with type 2 diabetes (two cards), one rat study, one product test of tablets and one crossover study of nausea.

Excluded: a 2024 Lebanese trial of apple cider vinegar, because it was retracted in 2025. A 2026 trial in polycystic ovary syndrome that measured metabolic outcomes and no inflammatory marker. Further animal and laboratory studies of other vinegars, two narrative reviews, a study of vinegar applied to the skin, and studies of persimmon vinegar and fermented food concentrates.

What we read: abstracts, and the full results section of the rat study.

What we could not get: a trial of barberry in apple vinegar in type 2 diabetes that reports inflammatory markers, found only on a journal site that is not indexed in PubMed and is outside our trusted sources. The full texts of the human trial and of the meta-analysis. Any agency or rheumatology society position in our trusted sources.

What would change this answer

A placebo-controlled trial of apple cider vinegar with high-sensitivity CRP, IL-6 or TNF as the main outcome.
A trial in people with arthritis that measures joint pain and function.
A meta-analysis that pools whatever inflammatory markers the existing vinegar trials recorded.

More on this food, including blood sugar and weight: apple cider vinegar.

The food behind this question

Apple cider vinegar: a real effect on one meal, a small one on weight — numbers, evidence and safety

The same question for other foods (inflammation)

Sources

ev-acvin-01 · Meta-analysis or systematic review · systematic review and meta-analysis of clinical trials · n = 1320
The present study aimed to perform a systematic review and meta-analysis of the effects of ACV consumption on lipid and glycemic parameters...Overall, 25 clinical trials (33 arms) comprising 1320 adults were entered in this study.
Who: adults in clinical trials of apple cider vinegar (33 arms)
Effect: scope limited to lipid and glycemic parameters; no inflammatory outcome in the scope
Certainty: The meta-analysis itself is not about inflammation; the map shows that there is no synthesis on CRP/IL-6.
Current Medicinal Chemistry, 2025, 32(11):2257-2274 · checked 2026-10-07 · we read the abstract
ev-acvin-02 · Randomized controlled trial(s) · randomized controlled parallel trial, 8 weeks · n = 70
Seventy participants with type 2 diabetes and hyperlipidemia were randomly assigned into an intervention and control group in order to assess the effect of 20 ml apple vinegar per day using an 8-week parallel study...The intervention with apple vinegar could significantly improve FBS (mean change: -10.16 ± 19.48 mg/dl, p = 0.006) and DPPH (mean change: 16.58 ± 11.56, p < 0.001) within intervention group and in comparison with control group (p < 0.001). Additionally, the significant increase of MDA in control group (p < 0.05) caused a considerable difference between two groups.
Who: 70 adults with type 2 diabetes and hyperlipidemia, apple vinegar 20 mL/day vs control
Effect: fasting glucose -10.16 mg/dl (p = 0.006), DPPH +16.58 (p < 0.001) vs control; MDA rose only in controls
Certainty: Small, without placebo and blinding per the abstract; oxidative stress is not inflammation: CRP, IL-6, TNF were not measured.
Clinical Nutrition ESPEN, 2019, 33:132-138 · checked 2026-10-07 · we read the abstract
ev-acvin-03 · Randomized controlled trial(s) · randomized controlled parallel trial, 8 weeks · n = 70
No considerable effect was observed on blood pressure and homocysteine in intervention group as well as control group.
Who: 70 adults with type 2 diabetes and hyperlipidemia
Effect: no considerable change in systolic or diastolic blood pressure or homocysteine in either group
Certainty: Null result of a small RCT; homocysteine is a marker of vascular risk, not inflammation as such.
Clinical Nutrition ESPEN, 2019, 33:132-138 · checked 2026-10-07 · we read the abstract
ev-acvin-04 · Laboratory or animal data · animal experiment · n = —
Additionally, Figure 5 illustrates that after 24 h, diclofenac (1%) presented the highest inhibition of inflammation (58.30%), followed by Golden Delicious vinegar (37.50%), Red Delicious vinegar (28.30%), and Starking Delicious vinegar, the latter of which showed only 21.67% inhibition of edema.
Who: rats, carrageenan paw edema model, vinegars from four apple cultivars
Effect: inhibition of edema at 24 h: diclofenac 58.30%, Golden Delicious vinegar 37.50%, Red Delicious 28.30%, Starking Delicious 21.67%
Certainty: Rats, dose 10 mL/kg; the effect depends on the apple variety. Does not transfer to humans.
Plants (Basel), 2023, 12(22):3850 · checked 2026-10-07 · we read the fulltext
ev-acvin-05 · Laboratory or animal data · product testing after an adverse event report · n = 8 products
After an adverse event was reported to the authors, eight apple cider vinegar tablet products were tested for pH, component acid content, and microbial growth. Considerable variability was found between the brands in tablet size, pH, component acid content, and label claims. Doubt remains as to whether apple cider vinegar was in fact an ingredient in the evaluated products.
Who: 8 apple cider vinegar tablet products
Effect: considerable variability in tablet size, pH, acid content and label claims between brands
Certainty: A single adverse event report plus a product analysis; about pills bought "for inflammation", not about diluted vinegar.
Journal of the American Dietetic Association, 2005, 105(7):1141-1144 · checked 2026-10-07 · we read the abstract
ev-acvin-06 · Randomized controlled trial(s) · randomized crossover acute feeding study · n = 16
Healthy, young, normal weight unrestrained eaters were recruited to Study 1 (n=16), an acute feeding study supplying vinegar within both palatable and unpalatable drinks alongside a mixed breakfast in comparison to a non-vinegar control...Both studies were a randomized crossover balanced design for the assessment of appetite, energy intake and glycaemic response. RESULTS: In Study 1, ingestion of vinegar significantly reduced quantitative and subjective measures of appetite, which were accompanied by significantly higher nausea ratings, with unpalatable treatment having the greatest effect.
Who: healthy, young, normal weight unrestrained eaters; vinegar in palatable and unpalatable drinks vs non-vinegar control
Effect: significantly higher nausea ratings after vinegar ingestion; reduced appetite largely explained by poor tolerability
Certainty: Acute study, one dose; shows tolerability, not long-term harm.
Int J Obes (Lond), 2014 · checked 2026-10-07 · we read the abstract

How this page was made. Evidence was extracted from primary sources into cards, every number was re-checked against the source, and the text was written from those cards. Bioma Learn has no human medical reviewer at this time, and we say so rather than invent one. Methodology. This is information, not medical advice.