Apple Cider Vinegar Does NOT Thin the Blood and Should Not Be Used as an Anticoagulant
Apple cider vinegar (ACV) has no established anticoagulant properties and should never be considered as a blood thinner or substitute for medical anticoagulation therapy. The available evidence actually suggests ACV may have anti-fibrinolytic effects, which would theoretically reduce blood thinning rather than enhance it.
Evidence Against Anticoagulant Properties
ACV inhibits fibrinolytic activity rather than promoting it. A study demonstrated that ingestion of 750 mL of cider inhibited plasma fibrinolytic activity and urokinase-induced clot lysis in a concentration-dependent manner 1.
The fibrinolytic activities of plasmin, urokinase, and tissue activator on fibrin plates were all inhibited by cider in a concentration-dependent manner, with the inhibitory activity being heat-stable and non-dialysable 1.
This anti-fibrinolytic effect is the opposite of what blood thinners do—medical anticoagulants like warfarin, heparin, and direct oral anticoagulants work by either inhibiting clotting factor synthesis or directly blocking coagulation enzymes 2.
What ACV Actually Does
ACV has demonstrated effects on lipid metabolism and glycemic control, not coagulation 3, 4, 5.
Studies show ACV reduces fasting blood glucose, HbA1c, LDL cholesterol, and triglycerides while increasing HDL cholesterol in diabetic patients 3, 4, 5.
ACV provides antioxidant effects by reducing lipid peroxidation and increasing antioxidant enzyme levels in animal models 6.
Critical Clinical Implications
Never recommend ACV as a substitute for prescribed anticoagulants in patients requiring therapeutic anticoagulation for conditions like deep vein thrombosis, pulmonary embolism, atrial fibrillation, or mechanical heart valves 2.
Patients requiring anticoagulation should receive evidence-based therapies including low-molecular-weight heparin (LMWH), unfractionated heparin, vitamin K antagonists (warfarin), or direct oral anticoagulants (DOACs) depending on their specific indication 2.
There is no evidence that ACV affects PT/INR, aPTT, or any standard coagulation parameters used to monitor anticoagulation therapy 2.
Potential Harm from Misconception
Patients who substitute ACV for prescribed anticoagulants face life-threatening thrombotic complications including stroke, pulmonary embolism, and systemic embolization 2.
The anti-fibrinolytic properties of ACV could theoretically increase thrombotic risk in susceptible individuals, though this has not been studied in clinical trials 1.
ACV has no role in the management of bleeding complications from anticoagulants, where vitamin K, prothrombin complex concentrates, or fresh frozen plasma are the appropriate interventions 2.