Apple Cider Vinegar and Probiotics

Written by: Kari Raman, PharmD, RPh
Published July 3, 2023

Apple cider vinegar (ACV) and probiotics are two popular supplements that many people incorporate into their health regimen. They each have potential benefits and uses and they’re items I frequently get asked about at the pharmacy. One question patients sometimes ask is, can you take apple cider vinegar and probiotics together? 

The basic answer is yes, for otherwise healthy people.

If you have a serious health condition, talk to your doctor! Don’t try to self treat it. And ask your pharmacist if you are taking medication to make sure that your supplements don’t interact with your prescribed medicines. 

Let’s dig in to see how the two work together, learn how ACV can kill probiotics if you aren’t careful, and more.

Apple cider vinegar is fermented – more on that later

Apple cider vinegar is a type of vinegar made from fermented apple juice. If you’ve read any of my other articles, you know that fermentation is a process that many foods that naturally contain probiotics go through. I’ll dig into the possible probiotics that this cider might contain later.

ACV vs. probiotics

ACV contains acetic acid, a substance that might aid in digestion and support a healthy gut environment; most do not contain active, living bacteria or probiotics. Raw apple cider vinegar may contain active cultures, although in my experience as a pharmacist, I haven’t see any of these active cultures that are proven to have probiotic-like health benefits. Probiotic supplements, on the other hand, are live bacteria and yeasts that might be helpful to our health, particularly the gut.

Is apple cider vinegar a probiotic?

Some raw apple cider vinegars may contain active cultures – which the manufacturer may claim have probiotic benefits. I haven’t seen medical research to back this up, so if you find an ACV that says it has the benefit of active cultures, first make sure it’s raw. Then you should ask which cultures it contains, then you can research the possible health benefits on my species page to see if there is evidence that the specific strain provides health benefits. Raw ACV is unpasteurized and unfiltered. Pasteurization is a manufacturing process that kills living organisms (it’s done to milk to prevent problems like bad bacteria making the milk go bad. So any product that is pasteurized shouldn’t have active cultures.

So, to summarize: raw ACV may have some active cultures in it, but it probably doesn’t have enough active cultures to be considered a probiotic. Pasteurized ACV does not have any probiotics in it, since pasteurization kills bacteria and yeasts.

Can you take apple cider vinegar with a probiotic?

The simple answer is yes, you can take probiotics and apple cider vinegar together. However, there are a few things to consider.

The acetic acid in apple cider vinegar could potentially impact the effectiveness of the probiotics if taken at the exact same time, as the acid can potentially kill bacteria – this research study showed that at high enough doses, ACV can kill bacteria. It’s probably not acidic enough, but seeing as how I’ve got a whole article suggesting that the best time to take probiotics is when you have the lowest stomach acid, why push it? 

One solution to this might be to consume them at separate times during the day, perhaps one in the morning and one in the evening. Also, as always, individual experiences and benefits can vary. It’s always recommended to talk to your healthcare provider before beginning a new supplement regimen. 

Does apple cider vinegar and probiotics work together?

Here’s a brief overview of how ACV and probiotics might complement each other:

Boosting digestion: ACV is known for its potential ability to help digestion by increasing stomach acidity, particularly in people with lower stomach acid levels. I’ve looked really, really hard to find a clinical trial or research study to back this up, but there really isn’t a ton of research out there. The best I think I could find is a study done on fish? Kinda strange research to be honest. But, to the extent that this cider helps the digestion and absorption of nutrients, it could potentially help probiotics as they support a healthy gut microbiota and improve digestion. 

Enhancing gut health: ACV might help maintain a healthy gut microbiota. When used in combination with probiotics, this could possibly result in a synergistic effect in terms of supporting overall gut health. I’ve found another study on fish, if you can believe it, suggesting that this synergy may exist. Not the strongest research, but it doesn’t scare me away from taking the two at the same time. And if I was a fish, for sure I would do it.

Supporting immune function: Both ACV and probiotics have been claimed to support immune function, albeit through different mechanisms. ACV might achieve this by promoting a healthy gut environment, while probiotics might support immune function by introducing beneficial bacteria that could interact with the immune system. I feel a lot better about the research on probiotics supporting immune health, but if you are taking ACV to try to help your immune system, I would consider adding a probiotic; doesn’t seem like it will hurt. And talk to your doctor!

Despite these potential benefits, it’s important to remember that everyone’s individual situation is different. What works for one person may not necessarily work for another. As with any supplement, please consult your healthcare provider before starting an ACV and probiotic regimen, especially if you have a weakened immune system or other underlying health conditions.

How do you take apple cider vinegar and probiotics?

The way to take ACV and probiotics can vary greatly depending on individual preferences and specific health concerns. 

For ACV, you might consider taking 1-2 tablespoons diluted in water before meals to potentially aid digestion. Never drink ACV undiluted, as its high acidity can harm tooth enamel and the throat.

As for probiotics, the appropriate dosage can depend on the specific strain and the individual’s health status. Commonly, probiotics are taken in doses ranging from 1 to 10 billion colony-forming units (CFUs) per day, but follow the manufacturer’s instructions or consult with your healthcare provider.

Best Apple Cider Vinegar with probiotics

Again, I suggest taking your ACV and probiotics at different times of the day to minimize the impact of the vinegar’s acid on the bacteria/yeasts, but some people like to take their supplements all at once – so here are some of the best options for those people.

Kor But Check Shot Apple Cider Vinegar Probiotics Shot

Kor Gut Check combines a small shot of ACV with added probiotics. The added bacteria is a Bacillus coagulans strain. B. coagulans has some well conducted research that shows that it can help mitigate the impact of IBS. Kor adds 1 billion CFUs, which is in the dosage range that I recommend. In addition to the “mother” vinegar, there are some other ingredients that make it taste a little better – some apple juice, some coconut water, and a little lemon. The biggest downside, I’d say, is that it’s pretty expensive. 

Get it directly from Kor

Check the price on Amazon

Bragg Organic Apple Cider Vinegar With the Mother

Bragg is a well known brand; their organic cider with mother should contain active cultures. Again, I don’t think that it’s the same as taking a bacteria or yeast supplement, but it’s an easily available brand. You can get it at Amazon, Walmart, and in most grocery stores, so it makes the list as the easiest to find. It’s also generally pretty reasonably priced.

Get it from Walmart

Find it on Amazon

Prowise Healthcare Apple Cider Vinegar Capsules with Bio Cultures Complex

This isn’t a liquid vinegar – instead Prowise has created a pill (ok, they call it a capsule) that combines two good bacteria with concentrated ACV. And some other ingredients like turmeric, ginger and black pepper. Plus it has inulin, which is a prebiotic fiber that may help the bacteria successfully colonize your gut. Read my article on prebiotics to learn more about how fiber can help your gut. I like the two bacterias that they’ve picked – Bifidobacterium bidum and Lactobacillus acidophilus. I’ve seen research that suggests that B. bidum can help with IBS, and I’ve also seen research on it combined with L. acidophilus showing the two together may help with lactose intolerance. There are other studies that show both of these individually may be helpful for a variety of gut issues, so I like the combination. 

I think they are sold out right now; check the manufacturer to see if they are back in stock

Garden of Life Apple Cider Vinegar Probiotic Gummies mykind Organics

These are a gummy supplement that combines concentrated ACV with two strains of probiotics – Bacillus coagulans and Bacillus subtilis. The first has some good research on how it may help improve gut health; I linked to one of those studies above. The second. B. subtilis, is pretty well studied in animals, but not as much in people. I’ve seen a bit of research that suggests that it might help for immune function. It’s got 2 billion CFUs, which is a great dosage of active bacteria. I also think it’s a great price.

Get it from the manufacturer

Check the price on Amazon

Does apple cider vinegar kill probiotics?

It can – there is enough acidity in ACV to possibly kill a probiotic supplement, so my opinion as a pharmacist is to take the two supplements at a different time to give your probiotic the highest probability of successfully colonizing your gut without getting killed by acidity in your stomach from the vinegar. Basically, acid kills bacteria – in fact, your stomach is built to be a little acid factory to kill dangerous pathogens. So if you increase the acidity, which can happen with ACV, you can kill the probiotic supplement if you take it at the same time. So spread out the doses!

Can you take apple cider vinegar and probiotics every day?

Yes, both ACV and probiotics can generally be taken daily. However, because everyone’s body responds differently to supplements, some people may experience side effects like an upset stomach. If side effects occur, it might be necessary to reduce the dosage or stop taking the apple cider vinegar. As always, it’s recommended to discuss this with your healthcare provider.

Does apple cider vinegar contain probiotics? 

While some types of raw, unfiltered apple cider vinegar, particularly those that include “the mother” (a murky, cobweb-like substance that naturally forms during the fermentation process) may contain some types of bacteria, it’s important to note that these are not the same as the types of bacteria typically found in probiotic supplements or fermented foods. I’ve got a whole article on the most common probiotic species you can read if you are looking for the right supplements to add to your diet. 

ACV is made through a two-step fermentation process that involves adding yeast to crushed apples, which ferments the sugars and turns them into alcohol. Then, specific bacteria (Acetobacter species) are added to further ferment the alcohol, turning it into acetic acid, which gives the vinegar its characteristic sour taste.

While the acetic acid bacteria used to produce vinegar are generally filtered out during the manufacturing process, raw, unpasteurized ACV, especially the kind that contains “the mother,” can contain some strains of beneficial bacteria, including Acetobacter. 

“The mother” is a colony of beneficial bacteria, similar to a kombucha SCOBY, that converts alcohol into acetic acid during fermentation. It looks like a cloudy, cobweb-like substance floating in the vinegar. Some people believe that “the mother” can have probiotic-like benefits, but more research is needed to fully understand its health impacts. I looked really hard to find convincing clinical trials to support this vinegar giving you these types of benefits, but didn’t find anything I think is really strong enough to put on my blog… yet! There is a lot of research happening, so hopefully we’ll find something compelling soon. 

It’s important to note that the types and amounts of bacteria in ACV are not the same as those found in probiotic supplements or fermented foods, which are specifically designed to support gut health. The health benefits of the bacteria found in ACV, if any, are not as well-studied or understood as those of probiotics. 

Finally, while apple cider vinegar does go through a fermentation process and can contain some bacteria, it is not generally considered a probiotic. Probiotics are defined as live microorganisms which, when administered in adequate amounts, confer a health benefit on the host. The potential health benefits of apple cider vinegar are primarily attributed to its acetic acid content rather than its potential bacteria content.

In conclusion, while it’s generally safe to take apple cider vinegar and probiotics together, the potential benefits can vary depending on individual circumstances. As with any health supplements, you really need to talk to your doctor before starting to take them. 

Does vinegar kill probiotics?

Vinegar, particularly its main ingredient acetic acid, possesses antimicrobial properties. This means it can kill or inhibit the growth of certain types of bacteria and fungi – so it can kill probiotics. However, if you are looking to disinfect an eating surface or something, I don’t think vinegar is the antimicrobial cleaning solution that I’d recommend. The amount of probiotics any specific vinegar kills will depend on the specific vinegar, the concentration, how resilient the strain is, and your unique gut conditions. And if you are wondering about foods that you eat, as I mentioned above, acetic acid can kill all or some of the bacteria and fungi supplements. So if you take the two at the same time, so I suggest spacing out the consumption of both.

What are Probiotics?

At the pharmacy, when patients ask about apple cider vinegar and probiotics, I usually find it’s a good idea to talk about what probiotics are.. So, what exactly are they?

Probiotics are live microorganisms, popularly dubbed as “good bacteria.” When ingested in sufficient quantities, they may offer health benefits to the host – primarily humans. Some actually are yeasts, which is pretty amazing! These beneficial microorganisms are present in an array of foods and supplements, and manufacturers often claim that they support the body’s native gut microbiota. 

How Do Probiotics Work?

The gut, a major part of our human body, is teeming with a vast array of helpful (and sometimes not helpful) bacteria, yeasts and more – the microbiome. Stuff in your life, like antibiotics, stress, or an imbalanced diet could mess up the balance between these beneficial and bad bacteria. This can cause a number of health conditions and a lot of stomach discomfort. Here, probiotics come into play. Consuming foods or supplements rich in probiotics may aid in rebalancing this equilibrium by infusing beneficial bacteria back into the system. Remember that many need to be refrigerated. And if you are looking for some recommendations, read my review of Florator vs Culturelle or Good Girl Probiotics. Or check out my article on how many you can take.

Potential Benefits of Probiotics

  • They may offer relief in conditions like diarrhea, especially if triggered by antibiotics. Common options you’d spot at pharmacies include Florastor and Culturelle, though there’s a spectrum of other variants to explore.
  • Probiotics might alleviate symptoms related to irritable bowel syndrome (IBS).
  • Some studies indicate that they could amplify the immune system by stimulating the generation of natural antibodies.
  • The connection between gut health and our mental state is gaining traction. Preliminary research hints that probiotics might play a role in mitigating symptoms of depression and anxiety.
  • For those conscious of heart health, certain probiotics may reduce LDL (bad) cholesterol and regulate blood pressure.
  • Additionally, specific probiotic strains might hinder the uptake of dietary fat in the intestine, potentially assisting in weight management.

There is still a lot of medical research to be done on them – we don’t know for sure all of the possible benefits, and not all of the health claims I’ve seen are really backed up by science. It’s vital to acknowledge the evolving nature of research in this domain. And, everyone’s gut is different, so just because a supplement works for someone doesn’t mean that it will work for everyone. And I always recommend you see your doctor if you are having a health issue, and before you begin any supplementation program. 

Pharmacist Kari Raman

I’m Kari Raman PharmD, RPh, and I am a licensed, practicing pharmacist. I hold a Doctorate in Pharmacy from The University of the Pacific, and I’ve served patients in retail, compounding and hospital pharmacies.

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I hope Pharmacist Probiotics helps you find out if there is a type of probiotic that works for you!