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

Noni (Morinda citrifolia)

Is it safe?

Adverse events

Limited assessment of safety has been carried out but there have been few adverse effects reported after using Noni and the fruit has been consumed as food for many years.1,2,11 In 2002, a review of safety of one Noni juice product by the European Scientific Committee on Food concluded that there were no indications of adverse effects from animal studies on subacute and subchronic toxicity, genotoxicity and allergenicity.11 A double-blind safety study of Noni fruit juice sponsored by a manufacturer carried out in 96 healthy volunteers did not reveal any significant adverse effects with up to 750ml noni juice daily for 28 days.28

Between 2005 and 2011, 7 cases of hepatotoxicity in previously healthy people were reported, 2 involving a tea or other herbal product, 4 involving a Noni juice and 1 involving an energy drink.2 It is unclear whether Noni juice was the cause of liver toxicity. Liver function tests improved once the Noni product was stopped but other ingredients or treatments may have been responsible. The possibility of product contamination during production was also raised as the root and bark contain anthraquinones.10 Subsequent analyses did not detect anthraquinones in the juice and several studies did not reveal toxicity.28-30 A review of the first 4 cases by the European Food Safety Authority (EFSA) in 2006 concluded that there was ‘no convincing evidence for a causal relationship between the acute hepatitis observed in the case studies reported and the consumption of noni juice’.19 In 2008 an EFSA Panel concluded that, on the basis of data provided, the use of dried Noni leaves for preparation of infusions was safe.21

Noni contains relatively high levels of potassium (similar to levels in orange and tomato juice) and a case of hyperkalaemia was reported in a patient with chronic renal insufficiency.7 Mineral content of commercial noni juices has been shown to vary widely.31


It is recommended that Noni is avoided in people with liver dysfunction.1,2 It is also suggested people with hyperkalaemia, kidney dysfunction, on low potassium diets, taking potassium-sparing diuretics or other drugs that increase potassium levels such as ACE inhibitors avoid using it.1,2 Toxicity tests in animals did not find evidence of toxicity from Noni juice to developing embryos and foetuses.32 However, large amounts of the fruit have been reported to cause an abortion and historically Noni root bark has been used as an abortifacient indicating it may be unsafe in pregnancy.


Due to the potassium content of some Noni juice products, there is a potential for interaction with drugs causing increased potassium levels.7, 31

One case has been reported of resistance to the anticoagulant, coumadin, due to the vitamin K content of the particular Noni product being used by the patient.33

A single-dose, randomized, open-label and 2-period crossover study in 20 healthy volunteers showed that the aqueous fruit extract influenced the motor activity of the gastrointestinal tract. The fruit extract enhanced the rate and the extent of ranitidine absorption, partly due the ability of its active component scopoletin to stimulate the 5-HT4 receptor.34


Other problems or complications

Commercial preparations of Noni occasionally contain Morinda officinalis as well as Morinda citrifolia which have been reported to stimulate the kidneys and can exacerbate urinary difficulties.

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


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