Noni Juice and Supplements Review Article

What Are the Benefits of Noni Juice? Get the Facts About Noni Juice and Supplements.

Medically reviewed and edited by Tod Cooperman, M.D.

Initially Posted: 11/22/2004

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What It Is:

Noni (Morinda citrifolia) is a small tree whose leaves, roots, bark, and fruit were traditionally used for topical ailments by a wide range of cultures across the Indian and Pacific Oceans. The word "Noni" is from Polynesia where much of the fruit is currently produced. During colonial times the plant was taken to Africa, S. America and the Caribbean where many local uses developed. Products specifically made from the juice of the noni fruit have been introduced into North America, Japan and Europe in recent years.

What It Contains:

Aside from its water content, noni fruit contains a large amount of carbohydrates, some protein, and a very small amount of fat. It also contains vitamin C, potassium and smaller amounts of other vitamins and minerals. A variety of plant chemicals with possible biological activity have been reported in noni juice, as discussed further below.

What It Does:

Traditional uses of noni:
Traditionally, it was the leaves, and not the fruit, of the noni that were most commonly used medicinally. The leaves have been employed as a bandage for wounds or chopped and placed inside wounds. Roots and inner stem bark are used for inflammatory and infectious conditions.

The immature fruit was occasionally used for internal remedies. The ripe fruit was used as a poultice for wounds, skin infections, and to promote lactation. The ripe fruit was not generally used orally as a medicine. Due to its strong odor, which has been described as vomit-like, the ripe fruit was not regularly used as food other than during times of famine.

Newer uses of noni:
Much of the current usage of noni has little to do with traditional usage and focuses on the ripe fruit taken orally, as opposed to topically. Many current uses stem from an article in the Pacific Tropical Botanical Garden Bulletin in 1985 by Richard Heinicke. In the article Heinicke claimed that noni fruit contains a compound, proxeronine, that is converted into a compound called xeronine. He contended that xeronine is useful in treating high blood pressure, menstrual cramps, arthritis, gastric ulcers, sprains, injuries, mental depression, senility, poor digestion, drug addiction and pain. The article also included the following claims (believed to be unsubstantiated or inaccurate):

· Noni must be taken on an empty stomach because a proenzyme that converts proxeronine to xeronine is susceptible to stomach acid.

· Cells contain proteins that have receptor sites for xeronine that also facilitate the activity of many active plant compounds.

· Noni is less effective and may have unexpected side effects if taken with caffeine, tobacco, or alcohol.

· Green fruit has more valuable components than ripe fruit.

There are other modern claims that noni juice is an immune system stimulant and is useful in AIDS, Epstein-Barr virus, cancer, lupus, and kidney problems. Noni has also been promoted for treating tuberculosis, diabetes, heart trouble, colds, influenza, counteracting side effects of kava, as a blood purifier, and as an insecticide for hair.

The evidence:
Unfortunately, many of the claims made in Heinicke's 1985 article are believed to be inaccurate or unsubstantiated. In fact, the very existence of the compounds xeronine and proxeronine are questionable. Good clinical studies with noni have yet to be performed, so there is currently little scientific evidence to either support or refute the claims of noni's effectiveness.

Due to noni's popularity, however, scientists have begun studying noni in the laboratory. The results have been intriguing. The juice is believed to contain polysaccharides which may have an immunostimulatory effect and scopoletin (also found in tomatoes and chilis) which may dilate blood vessels and have other effects. Several in vitro studies have shown noni juice stimulates tumor necrosis factor and several interleukins, suppresses cell transformation and proliferation of breast and colon carcinomas, and induces apoptosis (programmed cell death). It is believed that some of the compounds responsible for these effects are anthocyanins, which may emerge as useful compounds for testing the authenticity of noni products. Noni's leaves and roots contain other compounds with potential antibacterial and anti-cancer activity, but these plant parts are typically not sold as supplements.

Owing to noni's potential anti-cancer activity and use by people with cancer, the National Institute of Health is funding a clinical study of dried noni fruit extract in cancer patients at the Cancer Research Center of Hawaii. The first phase (which is to begin shortly and yield results in 2006), will define noni's maximum tolerated dose and potential toxicities. It will also collect preliminary information on the efficacy of noni in respect to anti-tumor and symptom control. The study also seeks to identify chemical constituents of noni so that its bioavailability and pharmacokinetics can be measured and assessed.

Ripe or sub-ripe, undecomposed fruits are used to make preserved juice drinks, freeze-dried fruit juice, concentrated extracts, powders, tinctures, and fruit leather. There is controversy over which form is better. Fresh juice is sweeter and easier to drink because it contains more sugar. Aged juice, made by bacterial fermentation, is said to have a strong but mellow flavor. Water-added juice is made allowing the fruit to sit in water and is technically a fruit "drink" and not a juice. The NIH-sponsored clinical study is using pills, each containing 500 mg of freeze-dried noni extract.

Manufacturers' recommendations on products range widely, as do the concentrations of noni in the products. Clinical trials have yet to establish the dose of noni fruit that is safe and effective in the treatment or prevention of any disease. However, it is believed that people can consume the equivalent of two to three fruits per day without problems.

Cautions:

· Noni is generally believed to be safe as a food. However, because noni is a plant in the coffee family, people with allergies or sensitivities to coffee may want to avoid using noni. Other related plant products that could involve cross-sensitivity include ipecac, quinine/quinidine, tonic water, gardenia oil, madder, and many natural red, orange or yellow dyes such as alizarin.

· Liver failure has been reported in a small number of cases where people were using noni juice or tea made from morinda. Two cases involved Tahitian Noni Juice. In most cases, liver function returned after discontinuation, but liver transplantation was required by one person. It has not, however, been established whether noni was the causative agent. It seems advisable to avoid noni if you have had liver problems and not to use noni along with medicines or supplements that may cause liver damage.

· Noni juice contains a large amount of potassium, which should be considered if taking medication that also raise potassium levels, such as certain blood pressure medications and warfarin.

· If you are counting calories or watching carbohydrate intake, be aware that noni juice, like other juices, may contribute both to your diet.

· The FDA has sent warning letters to several companies regarding unsubstantiated marketing claims — many of which repeat the claims made in Richard Heinicke's 1985 article. Products that have been the subject of recent warning letters in 2004 include "Noni Juice Liquid Herbal Supplement," "Noni Cleansing Formula AM/PM", and "Pure Hawaiian Noni Juice."

Quality Concerns:

· Unlike most herbals sold as supplements, quality standards have yet to be defined for noni products. Currently, there is no way to judge whether one product is more effective or safe than another.

· It has been reported that some companies have sold the left over by-products of juicing, i.e., the discarded seed/pulp/fiber material, drying and grinding it and deceptively selling it as "100% noni fruit powder." Such a product would not be expected to contain the compounds expected in true noni juice. (However, there is no evidence that the fruit is better than the seeds, nor that the seeds are bad in any way.)

· There are distinctive varieties of noni and possibly even more than one species being used as the source of fruit. Almost all of the published literature is based upon fruit from trees in Hawaii. However, most of the fruit being sold is from trees growing in French Polynesia, Samoa, Fiji, and other South Pacific islands which may have different chemical constituents.

· Noni fruit is often wild harvested (wild-crafted) and therefore not of consistent quality nor origin.

· Noni is also commercially grown and harvested. As with other commercially grown crops, pesticides may be used in its production. Noni fruit is often grown in countries with different laws regulating usage of pesticides and herbicides including ones that are no longer acceptable in the United States, Canada or Europe. Some growers, however, do have organic certifications.

· Some, but not all, noni juice is pasteurized. Pasteurization is a heat treatment intended to kill potential pathogens in food products and may prolong shelf-life. It has been argued, however, that pasteurization might also inactivate compounds with potential beneficial effect, but this has not been proven.

Conclusion:

Current usage of noni juice does not reflect its traditional usage and is driven predominantly by widely promoted claims that have yet to be substantiated or denied by clinical research. Laboratory research, however, suggests possible biological effects of noni juice. A clinical trial is underway to assess noni's effectiveness in cancer treatment and to better understand its chemical make-up.

Until more is known, it seems safe to use noni (other than potential allergic reaction), but its benefits remain unproven. The composition of noni products on the market may vary significantly due to a lack of standards and an optimal dosage has not been established.

References:

Proceedings of the 2002 Hawai'i Noni Conference, S.C. Nelsond (ed.), University of Hawaii at Manoa, College of Tropical Agriculture and Human Resources, 2003. Go to http://www.ctahr.hawaii.edu/ctahr2001/commodities/noni/2002conference.asp.

McClatchey, W. From Polynesian Healers to Health Food Stores: Changing Perspectives of Morinda citrifolia (Rubiaceae), Integrative Cancer Therapies, 1(2); 2002 PP. 110 - 220. Go to http://www.ctahr.hawaii.edu/ctahr2001/commodities/noni/Downloads/MorindaCitrifolia.pdf.

For more information regarding the NIH clinical trial of noni go to http://www.clinicaltrials.gov/show/NCT00033878. Patients are still being enrolled for participation in this study.

Information on this site is provided for informational purposes only. It is not an endorsement of any product nor is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease. Consumers should inform their healthcare providers of the dietary supplements they take.