Written by Karen Pilkington and the CAM-Cancer Consortium.
Updated March 15, 2017

Noni (Morinda citrifolia)

Does it work?

Systematic reviews, meta-analyses

No systematic reviews of Noni have been published.

Narrative reviews

Several narrative reviews have been published. Of those published recently, one concluded that some research suggested ‘broad potential health benefits’ and promising results had been reported for several constituents but increased use of Noni was probably due to effective marketing.14 A second review of the literature reached similar conclusions, highlighting the fact that knowledge about the chemistry of Noni had increased but there was still a lack of clinical research.6

Clinical trials

No randomised controlled trials have been conducted to assess the effects of Noni in cancer patients.

Two trials assessed the effects of Noni on levels of substances thought to increase the risk of developing cancer. A double-blind, placebo-controlled trial was conducted to assess antioxidant activity of Noni in smokers.22 A total of 285 heavy smokers were randomly allocated to placebo, 29.5ml (1 fluid ounce) Noni juice or 118ml (4 ounces) Noni juice per day for 30 days. Levels of plasma superoxide anion radicals and lipid hydroperoxide were reported to have decreased in the Noni groups. A second related study assessed levels of aromatic DNA adducts, a surrogate biomarker for risk of lung cancer, again in smokers who drank Noni juice for a month.23 Of 283 smokers recruited for the trial, 203 completed the study. The results indicated that Noni juice daily may reduce cancer risk in heavy cigarette smokers by blocking carcinogen-DNA binding or removing DNA adducts from genomic DNA. Both were preliminary studies. Over 25% of participants did not complete the trial although all patients were included in the analysis. Noni juice and the placebo seemed well matched but contained a mixture of grape and blueberry juice which could have contributed to some of the beneficial effects reported.

A phase 1 dose finding trial was carried out in 29 cancer patients.12 Patients with advanced cancer were treated with capsules containing 500mg of ripe Noni fruit extract. A dose of 2g was used initially then doses were increased by 2g to a maximum of 10g (20 capsules) daily. A minimum of 5 patients were observed at each dose level for 28 days. Quality of life, symptom status, response, toxicity and pharmacokinetics were measured. Effects on several quality of life measures were reported although these did not reach statistical significance, except for decrease in pain. No adverse effects or tumour response attributable to Noni were observed.

Pre-clinical studies

Pre-clinical studies have shown a range of actions potentially beneficial in cancer. Several of these are described under Mechanism of action. Preventative effects based on anti-carcinogenic activity via inhibition of TPA,5 tumour cell-selective anti-proliferative effects,24 anti-angiogenic activity,25 and stimulation of the immune system26 have all been reported. A recent report describes that Noni Juice was useful in suppressing tumour growth in a mice model for HER2/neu breast cancer in amounts equivalent to human dosages below 90 ml/day.27 Other actions not directly related to cancer have also been reported.

Citation

Karen Pilkington, CAM-Cancer Consortium. Noni [online document]. http://cam-cancer.org/The-Summaries/Herbal-products/Noni. March 15, 2017.

Document history

Assessed as up to date in March 2017 by Barbara Wider.
Assessed as up to date in April 2016 by Barbara Wider.
Assessed as up to date in January 2015 by Barbara Wider.
Assessed as up to date in August 2013 by Barbara Wider.
Summary first published in September 2012, authored by Karen Pilkington.

References

  1. National Center for Complementary and Integrative Health (NCCIH). Herbs at a glance: Noni. (updated November 2016). Available at: https://nccih.nih.gov/health/noni. Accessed 15th March 2017.
  2. Natural Medicines Comprehensive Database. Noni monograph. [online]. Available at: http://naturaldatabase.therapeuticresearch.com. Accessed 15th March 2017.
  3. Kew Royal Botanic Gardens. Scientific Research and Data. Rubiaceae. Available at: http://www.kew.org/science-research-data/directory/teams/rubiaceae/index.htm. Accessed April 2012.
  4. Wang MY, West BJ, Jensen CJ, Nowicki D, Su C, Palu AK, Anderson G. Morinda citrifolia (Noni): a literature review and recent advances in Noni research. Acta Pharmacol Sin. 2002 Dec;23(12):1127-41.
  5. Akihisa T, Matsumoto K, Tokuda H, Yasukawa K, Seino K, Nakamoto K et al. Anti-inflammatory and potential cancer chemopreventive constituents of the fruits of Morinda citrifolia (Noni). J Nat Prod 2007; 70(5):754-757.
  6. Potterat O, Hamburger M. Morinda citrifolia (Noni) fruit--phytochemistry, pharmacology, safety. Planta Med. 2007 Mar;73(3):191-9. Epub 2007 Feb 7
  7. Mueller BA, Scott MK, Sowinski KM, Prag KA. Noni juice (Morinda citrifolia): hidden potential for hyperkalemia? Am J Kidney Dis. 2000 Feb;35(2):310-2.
  8. McClatchey W. From Polynesian healers to health food stores: changing perspectives of Morinda citrifolia (Rubiaceae). Integr Cancer Ther. 2002 Jun;1(2):110-20; discussion 120.
  9. Akihisa T, Tochizawa S, Takahashi N, Yamamoto A, Zhang J, Kikuchi T, Fukatsu M, Tokuda H, Suzuki N. Melanogenesis-Inhibitory Saccharide Fatty Acid Esters and Other Constituents of the Fruits of Morinda citrifolia (Noni). Chem Biodivers. 2012 Jun;9(6):1172-87.
  10. MD Anderson Cancer Center. Complementary/Alternative Medicine Education Resources, Therapies: Noni Juice. Available at: http://www.mdanderson.org/education-and-research/resources-for-professionals/clinical-tools-and-resources/cimer/therapies/herbal-plant-biologic-therapies/Noni.html. Accessed April 2012.
  11. European Commission Scientific Committee on Food. Opinion of the Scientific Committee on Food on Tahitian Noni® juice. 2002. Available at: www.noni-pei.ru/ec.pdf. Accessed April 2012.
  12. Issell BF, Gotay CC, Pagano I, Franke AA. Using Quality of Life Measures in a Phase I Clinical Trial of Noni in Patients With Advanced Cancer to Select a Phase II Dose. J Diet Suppl. 2009;6(4):347-59.
  13. Tahitian Noni International. Noni is the difference. Available at: http://research.tni.com/united_kingdom/uk_english/research/difference.html. Accessed April 2012.
  14. Pawlus AD, Kinghorn DA. Review of the ethnobotany, chemistry, biological activity and safety of the botanical dietary supplement Morinda citrifolia (noni). J Pharm Pharmacol. 2007 Dec;59(12):1587-609.
  15. Hirazumi A, Furusawa E. An immunomodulatory polysaccharide-rich substance from the fruit juice of Morinda citrifolia (noni) with antitumour activity.Phytother Res. 1999 Aug;13(5):380-7.
  16. Pawlus AD, Su BN, Keller WJ, Kinghorn AD. An anthraquinone with potent quinone reductase-inducing activity and other constituents of the fruits of Morinda citrifolia (noni). J Nat Prod. 2005 Dec;68(12):1720-2.
  17. Boon HS, Olatunde F, Zick SM, Trends in complementary/alternative medicine use by breast cancer survivors: comparing survey data from 1998 and 2005. BMC Women’s Health 2007, 7, article 4.
  18. National Archives Foods Standards Agency. Noni Product Accepted. 2006. Available at: http://food.gov.uk/news/newsarchive/2006/jan/nonihnllc. Accessed 15th March 2017.
  19. European Food Safety Authority. Opinion on a request from the Commission related to the safety of noni juice (juice of the fruits of Morinda citrifolia). The EFSA Journal 2006; 376: 1-12.
  20. European Food Safety Authority. Opinion on the safety of Tahitian Noni® ‘Morinda citrifolia (noni) fruit puree and concentrate’ as a novel food ingredient. The EFSA Journal 2009; 998: 1-16.
  21. European Food Safety Authority. Safety of ‘leaves from Morinda citrifolia L.’: Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies. The EFSA Journal 2008; 769: 1-17.
  22. Wang MY, Peng L, Lutfiyya MN, Henley E, Weidenbacher-Hoper V, Anderson G. Morinda citrifolia (noni) reduces cancer risk in current smokers by decreasing aromatic DNA adducts. Nutr Cancer. 2009;61(5):634-9.
  23. Wang MY, Lutfiyya MN, Weidenbacher-Hoper V, Anderson G, Su CX, West BJ. Antioxidant activity of noni juice in heavy smokers. Chem Cent J. 2009 Oct 6;3:13.
  24. Arpornsuwan T, Punjanon T. Tumor cell-selective antiproliferative effect of the extract from Morinda citrifolia fruits. Phytother Res 2006; 20(6):515-517.
  25. Beh HK, Seow LJ, Asmawi MZ, bdul Majid AM, Murugaiyah V, Ismail N et al. Anti-angiogenic activity of Morinda citrifolia extracts and its chemical constituents. Nat Prod Res 2012.
  26. Brown AC. Anticancer Activity of Morinda citrifolia (Noni) Fruit: A Review. Phytother Res 2012; 26(10):1427-40. .
  27. Clafshenkel P, King TL, Kotlarczyk MB,Cline JM, Foster WG, Davis VL,Witt-Enderby P. Morinda citrifolia (Noni) Juice Augments Mammary Gland Differentiation and Reduces Mammary Tumor Growth in Mice Expressing the Unactivated c-erb B2 Transgene. Evidence-Based Complementary and Alternative Medicine 2012; doi: 10.1155/2012/487423.
  28. West BJ, White LD, Jensen CJ, Palu AK. A double-blind clinical safety study of Noni fruit juice. Pac Health Dialog. 2009 Nov;15(2):21-32.
  29. West BJ, Jensen CJ, Westendorf J. Noni juice is not hepatotoxic. World J Gastroenterol. 2006 Jun 14;12(22):3616-9.
  30. West BJ, Su CX, Jensen CJ. Hepatotoxicity and subchronic toxicity tests of Morinda citrifolia (noni) fruit. J Toxicol Sci. 2009 Oct;34(5):581-5.
  31. West BJ, Tolson CB, Vest RG, Jensen S, Lundell TG. Mineral variability among 177 commercial noni juices. Int J Food Sci Nutr. 2006 Nov-Dec; 57(7-8):556-8.
  32. Wang MY, Hurn J, Peng L, Nowicki D, Anderson G. A multigeneration reproductive and developmental safety evaluation of authentic Morinda citrifolia (noni) juice. J Toxicol Sci. 2011 Jan;36(1):81-5.
  33. Carr ME, Klotz J, Bergeron M. Coumadin resistance and the vitamin supplement "Noni". Am J Hematol. 2004 Sep;77(1):103.
  34. Nima S, Kasiwong S, Ridtitid W, Thaenmanee N, Mahattanadul S. Gastrokinetic activity of Morinda citrifolia aqueous fruit extract and its possible mechanism of action in human and rat models. Journal of Ethnopharmacology 2012; 142: 354–361.