For many years I have tried to produce a comprehensive review of apple cider vinegar and gout. I have finally given up, for a very simple reason.

Despite the high level of interest among gout sufferers for ACV (Apple Cider Vinegar), there is absolutely no scientific information to say that ACV is good for gout. Having said that, there is no evidence to say it does not work. There is just no information.

The only mentions of apple cider vinegar relating to gout or uric acid, are only acknowledgments that many people believe that ACV helps gout followed by declarations that there is no evidence for this.

I am intrigued that such strong support for the benefits of apple cider vinegar can exist alongside zero evidence, but there are three explanations of how this may happen.

Apple Cider Vinegar And Gout Purpose

Before we look at those explanations, let me explain why I wrote this. Most of my pages support the Purpose of GoutPal.com. That is, to help you build a better relationship with your professional health advisers. Unfortunately, there is a type of gout suffer that ignores professional health advice. For these people I developed GoutPal Plan for Gout Victims. But if you don’t believe you are a Gout Victim you should leave now to answer Questions for Gout Sufferers.

Is Apple Cider Vinegar For Gout A Placebo?

Placebo is a common consideration in medical trials. Doctors acknowledge that patients can get better with inert substitutes for medicines if they believe that the medication will work. Many drug trials compare the target drug against an inactive placebo. Drugs have to significantly outperform the placebo in order to be deemed effective.

I was surprised to see how effective placebos can be. Looking back on recent colchicine dosage trials, I noticed that the placebo success rate for pretend colchicine substitute is 15-17%. I.e. Almost 1 in 5 people report positive pain relief from something that has no medical properties. If you apply this to the US population[1], it equates to 1-1.5 million gout sufferers who are likely to report positive pain relief from an inert substance. Plenty of scope there for people to find gout pain relief from apple cider vinegar.

Please note that I am not suggesting that people are fooling themselves. Placebo is a well recognized medical phenomenon, and if it makes you feel better, that is not wrong. Unless it stops you from getting safe uric acid levels.

Is Apple Cider Vinegar For Gout A Coincidence?

If a gout flare is left untreated, it will usually disappear naturally after a few days. It is perfectly possible that the relief noted by ACV drinkers would have happened anyway. Scientific studies could be designed to take this into account, but without them, we are left with the possibility that gout pain relief from ACV is mere coincidence.

Is Apple Cider Vinegar For Gout Just Hydration?

The biggest component of ACV is water, and sufficient intake will prevent dehydration. We know from several studies that hydration is good for gout. So we are left with the possibility that ACV is effective in the same way that almost all fluids are.

Tasty ACV Placebo for Gout?

Apple Cider Vinegar And Gout: Next Steps

As there are no scientific studies on apple cider vinegar for gout, we are left with the conclusion that, if it works for you, then it is good. The biggest danger is that ACV, by whatever means, will help you cope with the pain, but if it only masks the symptoms whilst uric acid crystals continue to grow slowly, you are in danger. These deposits can destroy your joints slowly, so in later years, when you are least able to cope, you could be left with permanently crippled joints. Irrespective of pain, if you have ever had a gout attack, you must test uric acid at least once per year – more frequently if it is not stable, or you are unsure what your level is.

I guess that leads on to a further possibility. If you decide to test your own uric acid rather than leave it to your doctor, you could run your own experiments on the effects of apple cider vinegar on uric acid. If you do that, please share your results in the gout remedies forum, where you can also ask for advice on how to do it.

Leave Apple Cider Vinegar And Gout to continue with Step 3 of GoutPal Plan for Gout Victims.

Apple Cider Vinegar And Gout Comments

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Pre-2022 GoutPal visitor responses and associated research include:

How much apple cider vinegar should I drink for gout?

Sandosa asked, “How much apple cider vinegar should I drink for gout?”
Now this is a common question among Gout Victims. Unfortunately, I rarely get to learn why victims believe their Gout Prayers will be answered by ACV. But it is something to think about for people at Step 3 of GoutPal Plan for Gout Victims. Anyway, this ACV dosage question prompted me to check for any new research.

I couldn’t find any. But I did revisit one of the earlier studies that claimed no significant link between ACV and uric acid[2]. Now this diabetes study clearly states:

uric acid, AST, ALT, ALP did not show significant differences.

However, I thought I’d check their exact findings. This study gave one group of patients a dose of 15 ml apple cider vinegar daily for one month. With a placebo dose for the other group. Then compared uric acid levels before and after the treatment period. So for ACV-treated and placebo groups the changes were 5.15 to 5.19 mg/dL and 5.42 to 5.45 mg/dL respectively.

I believe they are right to call that change insignificant. Though if you’re pedantic you might note that the tiny increase in uric acid level is actually 0.01 mg/dL worse with apple cider vinegar. Leading me to suggest the answer to “How much apple cider vinegar should I drink for gout?” is “Less than one tablespoon per day.”

Please remember: to find more related pages that are relevant to you, it's usually faster to search for your biggest apple vinegar concern.

Note: I'm planning a new hub page for vinegar & gout. Because I've identified several different vinegars that affect uric acid. As well as new studies that throw new light onto how vinegars can affect gout. For now, see Balsamic Vinegar & Gout. Or see Is Vinegar Good for Gout.

Apple Cider Vinegar For Gout: References

  1. Title: Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Authors: Zhu Y, Pandya BJ, Choi HK. Published: Arthritis Rheum. 2011 Oct;63(10):3136-41. doi: 10.1002/art.30520.

    The prevalence of gout among US adults in 2007-2008 was 3.9% (8.3 million individuals).

  2. Mahmoodi, Mehdi, Seyed-Mostafa Hosseini-zijoud, Saeedeh Nabati, Mahboobeh Modarresi, Milad Mehrabian, Ahmadreza Sayyadi, and Mohammadreza Hajizadeh. “The effect of white vinegar on some blood biochemical factors in type 2 diabetic patients.” Journal of Diabetes and Endocrinology 4, no. 1 (2013): 1-5.

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