Medicinal use of Noni - Morinda citrifolia
Noni - Morinda citrifolia
noni, morinda, Indian mulberry, hog apple, canary wood
This fact sheet provides basic information about noni—common names, what the science says, potential side effects and cautions, and resources for more information.
Noni is an evergreen shrub or small tree that grows throughout the tropical regions of the Pacific Ocean, from Southeast Asia to Australia. Noni has a history of use as a topical preparation for joint pain and skin conditions. Today, noni fruit juice has folk uses as a general health tonic and for cancer and chronic conditions such as cardiovascular disease and diabetes.
The noni fruit is most commonly combined with other fruits (such as grape) to make juice. Preparations of the fruit and leaves are also available in capsules, tablets, and teas.
M. citrifolia grows in shady forests, as well as on open rocky or sandy shores. It reaches maturity in about 18 months, then yields between 4 and 8 kg (8.8 and 17.6 lb) of fruit every month throughout the year. It is tolerant of saline soils, drought conditions, and secondary soils. It is therefore found in a wide variety of habitats: volcanic terrains, lava-strewn coasts, and clearings or limestone outcrops, as well as in coralline atolls. It can grow up to 9 m (30 ft) tall, and has large, simple, dark green, shiny and deeply veined leaves.
The plant bears flowers and fruits all year round. The fruit is a multiple fruit that has a pungent odour when ripening, and is hence also known as cheese fruit or even vomit fruit. It is oval in shape and reaches 10–18 centimetres (3.9–7.1 in) size. At first green, the fruit turns yellow then almost white as it ripens. It contains many seeds. It is sometimes called starvation fruit. Despite its strong smell and bitter taste, the fruit is nevertheless eaten as a famine food and, in some Pacific islands, even a staple food, either raw or cooked. Southeast Asians and Australian Aborigines consume the fruit raw with salt or cook it with curry. The seeds are edible when roasted.
M. citrifolia is especially attractive to weaver ants, which make nests from the leaves of the tree. These ants protect the plant from some plant-parasitic insects. The smell of the fruit also attracts fruit bats, which aid in dispersing the seeds. A type of fruit fly, Drosophila sechellia, feeds exclusively on these fruits.
Nutrients and phytochemical
M. citrifolia fruit powder contains carbohydrates and dietary fibre in moderate amounts. These macronutrients evidently reside in the fruit pulp, as M. citrifolia juice has sparse nutrient content. The main micronutrients of M. citrifolia pulp powder include vitamin C, niacin (vitamin B3), iron and potassium. Vitamin A, calcium and sodium are present in moderate amounts. When M. citrifolia juice alone is analyzed and compared to pulp powder, only vitamin C is retained in an amount that is about half the content of a raw navel orange. Sodium levels in M. citrifolia juice (about 3% of Dietary Reference Intake, DRI) are high compared to an orange, and potassium content is moderate. The juice is otherwise similar in micronutrient content to a raw orange.
M. citrifolia fruit contains a number of phytochemicals, including lignans, oligo- and polysaccharides, flavonoids, iridoids, fatty acids, scopoletin, catechin, beta-sitosterol, damnacanthal, and alkaloids. Although these substances have been studied for bioactivity, current research is insufficient to conclude anything about their effects on human health. These phytochemicals are not unique to M. citrifolia, as they exist in various plants.
In Thai cuisine, the leaves (known as bai-yo, ใบยอ) are used as a green vegetable and the fruit (luk-yo, ลูกยอ) is added as a salad ingredient to some versions of somtam.
The green fruit, leaves, and root/rhizomes were traditionally used in Polynesian cultures to treat menstrual cramps, bowel irregularities, diabetes, liver diseases, and urinary tract infections.
Morinda bark produces a brownish-purplish dye that may be used for making batik. In Hawaii, yellowish dye is extracted from its roots to dye cloth
There have been recent applications for the use of M. citrifolia seed oil which contains linoleic acid, possibly useful when applied topically to skin, e.g., for anti-inflammation, acne reduction, or moisture retention.
Noni juice benefits
Noni juice is derived from the fruit of the Morinda citrifolia tree indigenous to Southeast Asia and Australasia.
Noni juice has been promoted as a cure for a number of human diseases. However, there is no evidence to support these claims.
Sold in capsule form, pulp powder was the first M. citrifolia product brought to the commercial market in Hawaii by Herbert Moniz of Herb's Herbs in 1992 after patenting a unique M. citrifolia dehydrating method.(US 5288491)
Regulatory warnings and safety testing
In August 2004, the US Food and Drug Administration issued a Warning Letter to Flora, Inc. for violating section 201(g)(1) of the Federal Food, Drug, and Cosmetic Act (the Act) [21 U.S.C. § 321(g)(1)]. Flora made twelve unfounded health claims about the purported benefits of noni juice as a medical product, in effect causing the juice to be evaluated as a drug. Under the Act, this necessitates all safety and clinical trial evidence for the juice providing such effects in humans.
The FDA letter also cited
1) absent scientific evidence for health benefits of the noni phytochemicals scopoletin and damnacanthal, neither of which has been confirmed with biological activity in humans, and
2) lack of scientific foundation for health claims made by two proponents of noni juice, Dr. Isabella Abbot and Dr. Ralph Heinicke.
Two other FDA letters have been issued for the same types of violations.
In the European Union, after safety testing on one particular brand of noni juice (Tahitian Noni), approval was granted in 2002 as a novel food by the European Commission for Health and Consumer Protection Directorate-General. In their report, the European Commission's Scientific Committee made no endorsement of health claims.
In 2005, two scientific publications as clinical case reports described incidents of acute hepatitis caused by ingesting noni juice. Research has pointed to anthraquinones found in noni roots, leaves and fruit as potentially toxic to the liver and other organs. These case reports were reviewed in 2006 by the European Food Safety Authority (EFSA), concluding that no causal link could be established. One government report, however, advises against consumption of noni products if one has a history of liver disorders.
The potential for toxicity caused by noni juices remains under surveillance by EFSA, individual food safety authorities in France, Finland and Ireland, and medical investigators in Germany. One review of toxicity tests and safety issues surrounding noni juice was published, finding that there were no adverse effects from consumption of the juice, but another review indicates that safety concerns about consuming noni products have not been adequately addressed in scientific studies.
The Physicians Desk Reference (PDR) for Non-Prescription Drugs and Dietary Supplements lists only one particular commercial brand of noni juice, with no side-effects mentioned. Consumers of noni juice are advised to carefully check labels for warnings which may say "Not safe for pregnant women" or "Keep out of reach of children."
Noni plants and juice have been promoted by practitioners of alternative medicine as a cure for a number of human maladies including HIV, heart disease and cancer. However, noni products may contain high amounts of potassium, leading to one advisory that people on potassium-restricted diets because of kidney problems should avoid using noni. Also, according to the American Cancer Society "there is no reliable clinical evidence that noni juice is effective in preventing or treating cancer or any other disease in humans".
What the Science Says
In laboratory research, noni has shown antioxidant, immune-stimulating, and tumor-fighting properties. These results suggest that noni may warrant further study for conditions such as cancer and cardiovascular disease. However, noni has not been well studied in people for any health condition.
NCCAM-funded research includes a study on noni for cancer to determine its safety and potential effects on tumors and symptoms, as well as a laboratory study of noni’s effects on prostate cancer cells. The National Cancer Institute is funding preliminary research on noni for breast cancer prevention and treatment.
Side Effects and Cautions
Noni is high in potassium. People who are on potassium-restricted diets because of kidney problems should avoid using noni.
Several noni juice manufacturers have received warnings from the U.S. Food and Drug Administration about making unsupported health claims.
Few side effects from noni have been reported, but its safety has not been adequately studied.
There have been reports of liver damage from using noni. It should be avoided if you have liver disease because it contains compounds that may make your disease worse.
Tell all your health care providers about any complementary health practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For tips about talking with your health care providers about complementary and alternative medicine, see NCCAM's Time to Talk campaign.
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