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

Noni (Morinda citrifolia)

Abstract and key points

  • Noni (Morinda citrifolia) is a medicinal plant from Pacific regions
  • Evidence on the effects in cancer patients is lacking
  • Few adverse effects have been reported

Noni (Morinda citrifolia), also known as Ba Ji Tian, Cheese Fruit and Indian Mulberry, is a Polynesian plant that has traditionally been used in medicinal remedies. Noni fruit juice has been the main focus of attention in recent years.

A wide range of indications have been proposed for Noni juice and it has been marketed as a general cure-all for conditions including cancer, depression, diabetes, drug addiction, heart disease and obesity. It is also claimed that Noni has general benefits on health.

In vitro and animal studies have shown potential antioxidant action, immune function stimulation, and anti-tumour activity but there have been few trials in humans for any condition and no randomised controlled trials in cancer patients. Preliminary studies have suggested protective effects in heavy smokers.

Few adverse effects have been reported although assessment of safety has been limited to date. Several cases of liver toxicity have been reported but these have not been documented to be caused by Noni juice. The potassium content in some noni juice products may cause problems in people with renal insufficiency, on low potassium diets or taking drugs likely to increase potassium levels.

While apparently widely used, evidence on the proposed benefits in cancer patients is lacking and assessment of safety is limited.

Read about the regulation, supervision and reimbursement of herbal medicine at NAFKAMs website CAM Regulation.

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

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.