Do apple cider vinegar or red yeast rice have health benefits, or is it all hype?

If you are on the internet for more than five minutes, you are bound to come across unusual wellness practices to fix what ails you. Whether it is eating a placenta to boost energy, swishing oil through your teeth to whiten them, or eating worms to combat autoimmune disease, there is seemingly no end of unlikely “therapies” out there.

But is there any merit to the claims?

“Many of these have some element of truth buried in them or they originated with some form of medical practice,” said Jaime Fineman, an assistant professor of clinical medicine at the Lewis Katz School of Medicine at Temple University.

That doesn’t mean the practices live up to their expectations or that they are free from risk, she said.

“Just because it is natural doesn’t mean it’s safe,” Fineman said.

Nor does it mean it has gold-standard clinical research backing its worth. But if a patient finds benefit in the therapy, Fineman said, she would not suggest stopping unless there were negative side effects or other serious risks.

What’s most important when using any supplement is to know exactly what you are taking, said Fineman.

Supplements are not regulated by the U.S. Food and Drug Administration, so there is no guarantee what exactly is in the supplement, that the product doesn’t contain unlisted ingredients, or that the dose of the ingredients is correct, she said.

Talk to your doctor and use research from a reputable website such as the National Institutes of Health, she said.

“It is important for us to know what patients are using,” she said. “Especially patients with multiple medical problems.”

Any over-the-counter product can have serious implications for some conditions, so don’t leave anything out.

Here are six popular products and practices that purport to have wellness benefits, and the research behind them.

Red yeast rice, a traditional Chinese culinary and medicinal product, has been marketed as a supplement to help lower cholesterol levels. The product, made by culturing rice with yeast, can contain high levels of monacolin K, an ingredient chemically identical to lovastatin, a statin drug used to lower cholesterol.

But it can carry the same side effects and drug interactions of lovastatin, including rhabdomyolysis, the breakdown of damaged skeletal muscle, which can harm the kidneys.

The FDA has determined that products that contain high levels of monacolin K are unapproved drugs and cannot be legally sold as dietary supplements.

In recent years, there has been an increased interest among U.S. women who have given birth in eating their placenta as a way to fend off postpartum depression, increase the quality of their breast milk, and boost energy.

Although it can be eaten raw or cooked, many women have opted to send their placenta to a company that specializes in the process of having it cleaned, sliced, and dehydrated. It can be ground into powder and then put into capsules or used in smoothies.

There are no known scientific benefits to eating a placenta, also known as placentophagy.

In 2016, a newborn was hospitalized numerous times with group B streptococcus sepsis. Doctors determined the infant’s mother had consumed placenta capsules containing the bacteria, which was then passed to the baby in her breast milk, the Centers for Disease Control and Prevention reported.

Oil pulling, also known as “kavala” or “gundusha,” is a traditional folk remedy practiced in ancient India that involves swishing sesame, olive, sunflower, or coconut oil through the teeth and mouth for up to 20 minutes on an empty stomach. It is reported to whiten teeth, improve oral health, and rid the body of toxins.

While the process is not considered harmful, studies on its effectiveness are limited. In one small study to evaluate whether using sesame oil had any effect on plaque-induced gingivitis, researchers found there was a small reduction in microorganisms that would contribute to the conditions.

But those who do oil pulling should exercise caution. There have also been reported cases of pneumonia among those who have aspirated while in the process of oil pulling.

The American Dental Association does not recommend it as a dental hygiene practice. The group suggests you brush your teeth twice a day and floss once, and refrain from using any tobacco products.

Drinking tart cherry juice every day has been touted as a way to relieve joint pain, help with sleep, improve brain health, and prevent muscle soreness.

Cherries are low in calories and contain fiber, vitamin C, and potassium, and are a good source of tryptophan, serotonin, and melatonin.

A 2018 study found that consuming cherries decreased exercise-induced muscle soreness and inflammation. Other studies have shown benefits for arthritis, diabetes, blood lipids, and sleep.

But before you head out to buy cases of cherry juice, be aware that many of the studies that have been done had limits, such as being funded by the cherry industry. Additional studies are needed.

And those with diabetes should be wary of the sugar content.

Apple cider vinegar is touted as a remedy for weight loss, and to lower cholesterol and blood sugar levels. But although it seems to be a favorite in the wellness community, there is very little science to show it works.

A 2016 study out of Algeria found rats that were fed a high-fat diet for 30 days along with a daily dose of apple cider vinegar didn’t eat as much as the control group, lost weight, and had improvements in blood glucose and cholesterol levels. But the study involved only 18 rats, some of which were in control groups.

Another study looked at regular vinegar as a natural appetite suppressant. It concluded that using or promoting vinegar to help with weight loss wasn’t appropriate because participants reported nausea and indigestion, and there were health risks, including injury to the esophagus.

Drinking the highly acidic vinegar over time is also known to damage tooth enamel. But when used as directed, apple cider vinegar does help make a tasty salad dressing.

Helminthic therapy is an experimental type of immunotherapy that involves ingesting worm-like parasites or their eggs in pill form. It has been used as an alternative treatment for allergies, asthma, autism, Crohn’s disease, multiple sclerosis, Sjogren’s syndrome, and ulcerative colitis.

Proponents of the therapy say that as our hygiene and living conditions improved, we have been exposed to fewer microbes and infectious agents, which has led to increases in autoimmune and inflammatory diseases.

There have been a limited number of clinical trials involving helminthic therapy, and all but one were outside the U.S. The therapy does not have FDA approval.