Noni Information By Ray Sahelian, M.D. Health benefit of noni juice and supplement

Noni Juice: Is it a Cure All or Just a Healthy Drink?
 

Over the last two decades, a growing number of people have become interested in the medicinal uses of noni juice, made from the fruit of the Indian mulberry (Morinda citrifolia) of the South Pacific Islands of Tahiti, and more recently from Hawaii.  Noni has been used in folk remedies by Polynesians for over 2000 years, and is reported to have a broad range of therapeutic effects, including antibacterial, antiviral, antifungal, antitumor, antihelminth, analgesic, hypotensive, anti-inflammatory, and immune enhancing effects. Noni juice is also promoted to enhance energy and wellbeing. Does modern noni research support these claims?

Noni chemistry
Noni has been documented to contain a mixture of anthraquinones, organic acids, xeronine, several vitamins (such as beta-carotene, niacin, riboflavin, thiamine), some minerals, iron and calcium. The potassium content of noni is similar to that in tomato juice and orange juice.

Noni Supplement
Noni grows extensively throughout the South Pacific, and was at one time the most widely used medicinal plant in the region. This evergreen shrub grows especially well in the rich volcanic ash of Hawaii. Some of the beneficial constituents of Noni include various terpene compounds, caproic and caprylic acids, vitamin C and alkaloids. However, Noni is famous for the presence of an alkoloid proxeronine, which is believed to be a precursor to xeronine.

Noni Supplement Facts
Noni (Morinda citrifolia) (fruit) 300 mg
   Freeze Dried Hawaiian

Suggested Use: As an herbal dietary supplement, take one noni capsule 1 or 2 times daily.

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Noni uses - benefit of noni juice or extract
What is the benefit of noni juice or noni products, anyway Claims have been made that noni fruit juice or noni extract improves the immune system, ultimately healing dozens of conditions ranging from addictions to varicose veins and yeast rash. What does the scientific research say about the benefit of noni juice and noni extract supplement?
Noni and cancer
Noni fruit juice contains a polysaccharide-rich substance called noni-ppt with anti-tumor activity. In a study performed at the University of Hawaii, administration of noni-ppt significantly enhanced the duration of survival of mice with lung tumor. The researchers say, "This suggests possible clinical applications of noni-ppt as a supplemental agent in cancer treatment."

Noni and cholesterol
Reductions in total cholesterol and triglycerides have been seen in smokers who drank a product containing juice from the fruit of the noni tree every day for a month. The study was funded by the manufacturer of the product, sold as Tahitian Noni Juice. Researcher Mian-Ying Wang, MD, says she first became interested in studying noni juice in 1999 after becoming convinced that it helped reduce her pain from a wrist fracture.
Noni and diabetes
In Java, noni has been part of the treatment for diabetes. Most of the folk uses for diabetes involve chewing the leaves or a combination of the plant and leaves. Chewing mulberry leaves releases and activates large amounts of mucilage or insoluble dietary fiber. The fiber may slow the absorption of simple sugars from the gut. The effect in most patients would be a slight reduction in the peak glucose level following a meal.

Noni for energy enhancement
Evaluation of the ergogenic potential of noni juice.
Phytother Res. 2007 Jun 29. Tianjin Medical University, Division of Pharmacology, Tianjin, P.R. China, 300070.
Noni fruit juice is an increasingly popular health food. Traditionally, noni fruit was used by Polynesians to combat fatigue. Clinical studies have revealed that noni juice consumption improves quality of life scores related to physical functioning and energy levels. To further evaluate the ergogenic (antifatigue and endurance promoting) potential of noni juice, aged mice were pretreated orally with increasing doses (10, 20 and 40 mL/kg body weight) of Tahitian Noni Juice and then compared with young and aged controls in the forced swim test and rotarod test. The average times of all Tahitian noni juice dose groups were significantly longer than the aged controls in both the swim test (36% to 45%) and the rotarod test (59% to 128%), and were similar to those of the young controls. This demonstrates not only an improvement in endurance but also in balance and flexibility. These results confirm the reported use of noni juice to combat fatigue, improve endurance and increase overall physical performance.

Infections
 Infections are the most common applications of noni. The extract from the leaves of noni (not the fruit that renders noni juice) displayed a moderate suppression of Ascaris lumbricoides (intestinal nematodes) growth in the test tube. However, noni juice has not been shown to improve infections once symptoms have manifested, although there are anecdotal reports of patients feeling better from mild infections after using noni. Decoctions of the leaves or roots of related mulberry species may have some suppressive effect on parasitic infections.

Noni and pain
Pain, painful inflammation and swellings are the second most common usage of noni. Studies in mice have demonstrated that extracts from the root of noni (again, not rendered from the fruit) have some pain relieving and sedative activity.

Side effects of noni and noni juice
In some regions of the world noni and other mulberry species are used as a laxative. Predictably, some patients using higher concentrations of noni juice may experience some diarrhea. Although the risk of long-term adverse reactions is not currently known, it should be very low, because of the long history of mulberry species as a food in wide geographic regions. Patients with diabetes would be wise to find out the amount of sugars used to sweeten the particular product they wish to use.
   There have been two reported cases in the medical literature (both in Austria) regarding liver damage due to excessive noni juice consumption. As with any herb, it is best to use low amounts. I prefer using small amounts of different herbs as opposed to a large amount of a single herb. I also think that some herbs are healthy to ingest in small amounts, yet they have a potential to be harmful if used in excessive dosages. There is a possibility that noni itself was not the problem in these cases, but something else in the juice.

Noni product availability
The noni fruit is available as noni juice and noni extract capsules. You will also find Tahitian noni and Hawaiian noni juice. I'm not aware of the differences.

Noni dosage
Suggested noni dose is one or two capsules per day, taken with a few ounces of water. Three capsules are equivalent to about two tablespoons of liquid noni juice. A concentrated form of the juice is also available. Noni is often mixed with other fruit juices because of its unpleasant taste.

Noni summary by Ray Sahelian, M.D.
At this point, there are few scientific data to support the use of a noni extract or noni juice as a substitute for any standard medical treatment. Patients who are looking for additional help in treating mild infections, cancer or chronic pain could try noni, realizing that the benefits are likely to be minimal. Perhaps future research will give us additional clues to the potential therapeutic benefits of using noni juice or noni powder for cancer, diabetes, immune deficiency or other conditions. In the meantime, due to its content of various nutrients, noni juice and noni supplement are healthy to consume as part of an overall balanced diet. However, we discourage high dose noni use for prolonged periods until more long term human research is available.

Does noni cause harm to the liver, does noni cause hepatitis?
There have been some reports that noni has caused liver harm, but this matter has been disputed.

Hepatotoxicity of noni juice: report of two cases.
World J Gastroenterol. 2005 Aug 14;11(30):4758-60.
Department of Internal Medicine, Medical University Graz, Austria.
Noni juice (Morinda citrifolia) is an increasingly popular wellness drink claimed to be beneficial for many illnesses. No overt toxicity has been reported to date. We present two cases of novel hepatotoxicity of noni juice. Causality of liver injury by noni juice was asses-sed. Routine laboratory tests and transjugular or percutaneous liver biopsy were performed. The first patient underwent successful liver transplantation while the second patient recovered spontaneously after cessation of noni juice. A 29-year-old man with previous toxic hepatitis associated with small doses of paracetamol developed sub-acute hepatic failure following consumption of 1.5 L noni juice over 3 wk necessitating urgent liver transplantation. A 62-year-old woman without evidence of previous liver disease developed an episode of self-limited acute hepatitis following consumption of 2 L noni juice for over 3 mo. The most likely hepatotoxic components of Morinda citrifolia were anthraquinones. Physicians should be aware of potential hepatotoxicity of noni juice.

Noni juice is not hepatotoxic.
World J Gastroenterol. 2006 Jun 14. West BJ, Jensen CJ, Westendorf J. Research and Development Department, Tahitian Noni International, American Fork, UT 84003, USA.
Noni juice has been approved for use as a safe food within the European Union, following a review of safety. Since approval, three cases of acute hepatitis in Austrian noni juice consumers have been published, where a causal link is suggested between the liver dysfunction and ingestion of anthraquinones from the plant. Measurements of liver function in a human clinical safety study of Tahitian Noni Juice, as well as subacute and subchronic animal toxicity tests revealed no evidence of adverse liver effects at doses many times higher than those reported in the case studies. Additionally, noni anthraquinones occur in the fruit in quantities too small to be of any toxicological significance. The available data reveals no evidence of liver toxicity.

Septempter 2006 - The European Union's food safety agency EFSA has found no "convincing evidence" of a link between noni juice and four reported cases of hepatitis in Austria and Germany. Noni juice, made from the fruit of the Morinda Citrifolia plant, sometimes known as the Indian Mulberry, hit shelves across Europe after it was authorized by the European Commission in 2003 for the market. Austria's health and food safety body sounded a warning in 2005 after three acute hepatitis cases were reported. EFSA said its expert panel on dietetic products, nutrition and allergies examined the Austrian and Germany cases in which the people who consumed noni juice later came down with hepatitis. "The NDA Panel came to the conclusion that there is no convincing evidence for a causal relationship between the acute hepatitis observed in the case reports and the consumption of noni juice," EFSA said in a statement. "On the basis of the available information, it is unlikely that consumption of noni juice at the observed levels of intake induces adverse human liver effects," it said.

Noni Research Update
Inhibition of angiogenic initiation and disruption of newly established human vascular networks by juice from Morinda citrifolia ( noni ).
Angiogenesis. 2003;6(2):143-9.
Noni, the juice of the fruit from the Morinda citrifolia plant, has been used for centuries as a medicinal agent. We tested the effects of noni juice in a three-dimensional fibrin clot matrix model using human placental vein and human breast tumor explants as sources for angiogenic vessel development. Noni in concentrations of 5% (vol/vol) or greater was highly effective in inhibiting the initiation of new vessel sprouts from placental vein explants, compared with initiation in control explants in media supplemented with an equivalent amount of saline. These concentrations of noni were also effective in reducing the growth rate and proliferation of newly developing capillary sprouts. When used at a concentration of 10% in growth media, noni was able to induce vessel degeneration and apoptosis in wells with established capillary networks within a few days of its application. We also found that 10% noni juice in media was an effective inhibitor of capillary initiation in explants from human breast tumors. In tumor explants which did show capillary sprouting, the vessels rapidly degenerated (2-3 days) in those exposed to media supplemented with 10% noni.

Antitumour potential of a polysaccharide-rich substance from the fruit juice of Morinda citrifolia ( Noni plant ) on sarcoma 180 ascites tumour in mice.
Phytother Res. 2003 Dec;17(10):1158-64.
An immunomodulatory polysaccharide-rich substance ( Noni -ppt) from the fruit juice of Morinda citrifolia has been found to possess both prophylactic and therapeutic potentials against the immunomodulator sensitive Sarcoma 180 tumour system. The antitumour activity of Noni -ppt produced a cure rate of 25%-45% in allogeneic mice and its activity was completely abolished by the concomitant administration of specific inhibitors of macrophages (2-chloroadenosine), T cells (cyclosporine) or natural killer (NK) cells (anti-asialo GM1 antibody). Noni -ppt showed synergistic or additive beneficial effects when combined with a broad spectrum of chemotherapeutic drugs, including cisplatin, adriamycin, mitomycin-C, bleomycin, etoposide, 5- fl uorouracil, vincristine or camptothecin. It was not beneficial when combined with paclitaxel, cytosine arabinoside, or immunosuppressive anticancer drugs such as cyclophosphamide, methotrexate or 6-thioguanine. Noni -ppt also demonstrated beneficial effects when combined with the Th1 cytokine, interferon gamma, but its activity was abolished when combined with Th2 cytokines, interleukin-4 or interleukin-10, thereby suggesting that Noni -ppt induces a Th1 dominant immune status in vivo.

From Polynesian healers to health food stores: changing perspectives of Morinda citrifolia (noni).
Integr Cancer Ther. 2002 Jun;1(2):110-20; discussion 120.
Morinda citrifolia L (noni) is one of the most important traditional Polynesian medicinal plants. Remedies from isolated Polynesian cultures, such as that of Rotuma, illustrate traditional indications that focus upon leaves, roots, bark, and green fruit, primarily for topical ailments. Anecdotally collected Hawaiian remedies that employ noni fruit illustrate changing usage patterns with shifts in recent times to preparation of juice made of ripe or decaying fruit. Ralph M. Heinicke promoted a wide range of claims about noni, and these seem to have fueled much of the current commercial interest in the plant. Recent studies of the proliferation of commercial products have shown that noni product manufacturers are promoting a range of therapeutic claims. These claims are based upon traditional Polynesian uses, Heinicke's ideas, and fragments of recent scientific studies including the activity of noni in the treatment of cancer. A review is provided of recent studies of potential anticancer activity of noni fruit. While noni's anticancer potential is still being explored, it continues to be widely used by Polynesians and non-Polynesians alike for both traditional and newly hypothesized indications.

From Polynesian healers to health food stores: changing perspectives of noni plant - Morinda citrifolia (Rubiaceae).
Integr Cancer Ther. 2002 Jun;1(2):110-20; discussion 120.
Noni is one of the most important traditional Polynesian medicinal plants. Remedies from isolated Polynesian cultures, such as that of Rotuma, illustrate traditional indications that focus upon leaves, roots, bark, and green fruit, primarily for topical ailments. Anecdotally collected Hawaiian remedies that employ noni fruit illustrate changing usage patterns with shifts in recent times to preparation of juice made of ripe or decaying fruit. Ralph M. Heinicke promoted a wide range of claims about noni, and these seem to have fueled much of the current commercial interest in the plant. Recent studies of the proliferation of commercial products have shown that noni product manufacturers are promoting a range of therapeutic claims. These claims are based upon traditional Polynesian uses, Heinicke's ideas, and fragments of recent scientific studies including the activity of noni in the treatment of cancer. A review is provided of recent studies of potential anticancer activity of noni fruit. While noni's anticancer potential is still being explored, it continues to be widely used by Polynesians and non-Polynesians alike for both traditional and newly hypothesized indications.

Noni juice (Morinda citrifolia): hidden potential for hyperkalemia?
Am J Kidney Dis. 2000 Feb;35(2):310-2.
We report the case of a man with chronic renal insufficiency who self-medicated with an alternative medicine product known as noni juice (Morinda citrifolia). The patient presented to the clinic with hyperkalemia despite claiming adherence to a low-potassium diet. The potassium concentration in noni juice samples was determined and found to be 56 mEq/L, similar to that in orange juice and tomato juice. Herbal remedies and alternative medicine products may be surreptitious sources of potassium in patients with renal disease.

Noni plant emails
Q. I came across a web site that claimed noni juice, derived from the noni fruit, can treat or cure cancer, hypertension, sinusitis, ulcers, depression, lupus, herpes, hepatitis and heart disease. Is this true?
   A. There is no noni research in humans that we could find that supports the various claims made about noni juice or noni powder supplement.

Q. Is the benefit of Tahitian noni more than other types of noni from other islands such as Hawaiian noni?
   A. More important than which island noni is from is how it is grown and prepared and how clean the manufacturing process and the reliability of the company selling the noni product. Most likely, whether it is noni from Tahiti or noni from Hawaii probably makes little difference in practical terms.

Q. Is cancer prevention a benefit of morinda noni juice or noni powder?
   A. This is impossible to say. No long term human trials are available to tell us whether a benefit of morinda or noni is cancer prevention or treatment.

Q. Is the noni juice health benefit similar to noni supplement ?
   A. Probably not since noni juice is sometimes mixed with other juices, but if it is pure noni juice, then the health benefit would be similar to the noni powder sold as a noni capsule supplement.

Q. Is morinda noni drink different that noni juice ?
   A. There are dozens of companies, national and international, that make various noni products. Each company's noni product, whether noni juice or noni drink, is likely to be slightly or moderately different in terms of composition. Whether for practical purposes this makes any differences as far as the health benefit of noni product, this is difficult to say.

Q. Is noni a scam ? I hear so much about everything that noni is supposed to heal. I don't know whether I should buy noni juice or whether it is a scam.
   A. Yes and no. Noni probably has some health benefit, but it is too early to say what the benefits are. However, it is a scam to make all kinds of healing claims about noni when little human research is available.

Q. Does noni juice lead to weight loss?
   A. I doubt if noni juice or noni drink have weight loss potential.

Q.  I am contacting you in an attempt to get information on the noni juice which I have been made aware will provide relief from this malicious disease. My brother in law in Switzerland recently has been diagnosed with pancreatic cancer. They have gone in and relieved the fluids from his pancreas. They are considering chemo depending on the test results and his present health condition. Do you think noni juice will help? If so how may we obtain the noni juice? What is the recommended noni juice dosage? and of course what is the cost associated with noni juice?
   A. There are no studies with noni juice and pancreatic cancer, therefore not much can be said on this topic.

Q. Do you have any noni testimonials?
   A. We have had some people email us noni testimonials but we suspected they were noni suppliers or sellers and the noni testimonials did not seem to be believable. We are still waiting for a reliable testimonial to be emailed to us.

Q. Have you tried herbal noni tea?
   A. Not yet but I suspect herbal noni tea would not be pleasant tasting unless it is mixed with other herbs.

Q. I understand that you are somehow involved in the distribution / purchasing / marketing or writing about noni products. Have you heard about the recent bad publicity noni products are receiving? According to a website, the American Cancer Society has published information about the Noni Plant and concludes that "there is no scientific evidence that noni juice is effective in preventing or treating cancer or any other disease". The information also mentions that "proponents claim that the noni fruit and its juice can be used to treat cancer, diabetes, heart disease, cholesterol, high blood
pressure, HIV, rheumatism, psoriasis, allergies, infection, and inflammation". The final conclusion and advice is that "the safety and long-term effects of noni juice and other noni products are not known. However, relying on this type of treatment alone, and avoiding conventional medical care, may have serious health consequences".
   A. Everybody has their own opinion about noni, and we stand by our noni information on this web page.

Q. I have been taking noni juice for over a month at the rate of one tablespoon, twice a day and was wondering when I would get a boost of energy. I'm also itching really bad now for approximately two weeks usually when I'm asleep in bed and was wondering if that is the detox spell that everybody goes through. I understand noni juice goes to the colon. Also was wondering if the high level of potassium and or sugar that noni has, would effect the renal cell make-up of the kidneys. I've been reading some forums on this. My mother died of renal cell carcinoma kidney cancer at a young age and I don't want to die as a result of some thing that I thought would benefit me. I'm afraid to increase my noni dosage because of my concerns of the large amounts of potassium to the kidney or liver. I'm 58 years old and have noticed an improvement in the digestion of food. I'm still looking for an improvement in the arthritis pain.