Moringa oleifera

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Moringa oleifera

Common Names

  • Horseradish tree
  • Drumstick tree
  • Benzolive tree
  • Ben oil tree

For Patients & Caregivers

How It Works

Moringa oleifera is traditionally used for a variety of conditions, but studies in humans are limited.

Moringa oleifera is an edible plant that is cultivated worldwide. The leaves and seed pods are consumed as food. Extracts from its leaves, bark, seed pods, and pulp are also used in a variety of folk medicine treatments, either given by mouth or as a topical agent applied to the skin. Products derived from this botanical are used to treat a variety of conditions including asthma, diabetes, ulcers, infections, and cancer. However, data is quite limited and it has not been adequately studied in humans.

Purported Uses
  • Antimicrobial
    Lab studies suggest that various moringa extracts may stop the growth of bacteria and fungi, but human data are lacking.
  • Anti-inflammatory
    Lab studies suggest moringa seed extract and compounds isolated from the fruit may prevent inflammation. Further research is needed.
  • Diabetes
    Lab studies suggest moringa may reduce blood glucose levels and have potential as an antidiabetic agent, but well-designed human studies are needed.
  • Anti-ulcer
    Lab studies suggest moringa extracts can protect against digestive ulcers, but human studies are needed.
  • High cholesterol
    A small study showed a mild positive impact on lipid profiles in patients with hyperlipidemia.
Patient Warnings
  • Although moringa leaves are a part of the diet in some regions of the world, lab studies indicate that parts of the plant, especially the bark and the pulp, may be harmful in large doses.
Do Not Take If
  • You are taking CYP450/CYP3A4 substrate drugs: Lab studies suggest moringa may increase the side-effect risks of these drugs. Clinical relevance has yet to be determined.
  • You are taking the diabetes medication sitagliptin: In an animal model, moringa decreased the antihyperglycemic effects of sitagliptin. Clinical relevance has yet to be determined.
  • You are pregnant: Moringa bark may cause uterine contractions, and has been used to induce abortion in some cases.
Side Effects

Case report

Stevens-Johnson Syndrome: In a 53-year-old man with diabetes and hypertension who was admitted with fever, rash, painful blisters and swallowing difficulties. Onset was about 14 hours after consuming food containing moringa leaves. A similar episode occurred 3 months prior after consuming curry containing moringa leaves.

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For Healthcare Professionals

Scientific Name
Moringa oleifera
Clinical Summary

Moringa oleifera (MO) is an edible plant native to Asia and Africa that is also cultivated around the world. The leaves and seed pods are nutritious and widely consumed as food while the bark and root are used in folk remedies for their perceived medicinal properties. Products derived from this botanical are used to treat a variety of conditions including asthma, diabetes, ulcers, infections, and cancer. In addition, the plant extracts are used in primitive water filtration systems to remove pollutants and algae (1).

Preclinical studies suggest various properties with MO leaf, seed, and root extracts, including anticancer (3) (4), hepatoprotective (10), hypoglycemic (12) (41), anti-inflammatory (13) (14), antibacterial (18) (19) (42), antifungal (20), antiviral (21), and antisickling (37) effects. Models suggest potential to protect against Alzheimer’s disease (29) and digestive ulcers (24) (43), promote wound healing (30), and lower cholesterol levels (25).

Studies in humans are quite limited. Preliminary findings suggest MO exerts a small positive effect on lipid profiles (38). An MO leaf powder increased insulin secretion in healthy subjects (44), and improved nutritional status and intake of AIDS patients undergoing antiretroviral therapy (45). A systematic review determined that well-designed human studies on safety and utility of moringa in diabetic or prediabetic patients are needed (48).

Food Sources

Moringa leaves are eaten in many parts of the tropics where the trees are found.

Purported Uses
  • Antimicrobial
  • Anti-inflammatory
  • Diabetes
  • Ulcers
  • Cholesterol levels
Mechanism of Action

Moringa is a nutritionally rich botanical with a high polyphenol content, including phenolic acids, flavonoids, and glucosinolates (48). In preclinical studies, fiber content of MO leaves mediated quercetin-3-glucoside to improve glucose tolerance (7) (12). Phenolic glycosides from the fruit show anti-inflammatory effects by inhibiting nitric oxide (13). Dipeptide and urea derivatives from MO roots also have anti-inflammatory and antinociceptive effects (14). The ethanolic seed extract produced immunosuppressive and anti-inflammatory effects by inhibiting leukocytes and splenocytes (15) as well as histamine release from mast cells (16).

In an animal model, MO root extract demonstrated protective effects on the liver and kidney in a dose-dependent manner (22). Hepatoprotective effects from acetaminophen toxicity may occur by maintaining glutathione levels (11). MO extract may protect against stomach ulcers by modulating 5-HT3 receptors (24) and lower cholesterol by inhibiting HMG-CoA reductase (25).

Lab experiments suggest an array of other properties in this botanical. A leaf extract exhibited protective effects against Alzheimer’s disease by modulating brain monoamines (29). It also may help promote wound healing by increasing collagen deposits (30). Anticancer effects may occur via apoptosis (3) (4) and NF-kappaB inhibition (5) (46). In an animal model, an MO extract helped prevent chemically-induced tumor formation by increasing glutathione activity (6).

A moringa water extract showed hormone-modulating properties, stimulation of uterine and cervical epithelium metaplasia (26) (27), and antifertility effects (28). In a murine model, MO was genotoxic at supra-supplementation levels of 3,000 mg/kg body weight (39). In a case report of Stevens-Johnson Syndrome linked to ingestion of moringa, pathogenesis may be related to an immunomodulatory effect such as a delayed Th1-mediated hypersensitivity reaction (49).

Adverse Reactions

Case report

Stevens-Johnson Syndrome: In a 53-year-old man with diabetes and hypertension who was admitted with fever, rash, painful blisters and swallowing difficulties. Onset was approximately 14 hours after consuming food containing moringa leaves. A similar episode occurred 3 months prior after consuming curry containing moringa leaves (49).

Herb-Drug Interactions
  • Cytochrome P450 substrates, including CYP3A4: In preclinical models, moringa increased the bioavailability of rifampin (34) and inhibited CYP3A4 (35). Clinical relevance has yet to be determined.
  • Sitagliptin: In an animal model, chronic co-administration with moringa decreased antihyperglycemic effects of sitagliptin (47). Clinical relevance has yet to be determined.
Herb Lab Interactions

Preclinical studies suggest moringa may reduce blood glucose levels (7) (12).

Dosage (OneMSK Only)
References
  1. Lurling M, Beekman W. Anti-cyanobacterial activity of Moringa oleifera seeds. J Appl Phycol. Aug 2010;22(4):503-510.
  2. Guevara AP, Vargas C, Sakurai H, et al. An antitumor promoter from Moringa oleifera Lam. Mutat Res. Apr 6 1999;440(2):181-188.
  3. Kalkunte S, Swamy N, Dizon DS, Brard L. Benzyl isothiocyanate (BITC) induces apoptosis in ovarian cancer cells in vitro. J Exp Ther Oncol. 2006;5(4):287-300.
  4. Satyan KS, Swamy N, Dizon DS, et al. Phenethyl isothiocyanate (PEITC) inhibits growth of ovarian cancer cells by inducing apoptosis: role of caspase and MAPK activation. Gynecol Oncol. Oct 2006;103(1):261-270.
  5. Lampronti I, Khan MT, Bianchi N, et al. Bangladeshi medicinal plant extracts inhibiting molecular interactions between nuclear factors and target DNA sequences mimicking NF-kappaB binding sites. Med Chem. Jul 2005;1(4):327-333.
  6. Bharali R, Tabassum J, Azad MR. Chemomodulatory effect of Moringa oleifera, Lam, on hepatic carcinogen metabolising enzymes, antioxidant parameters and skin papillomagenesis in mice. Asian Pac J Cancer Prev. Apr-Jun 2003;4(2):131-139.
  7. Sreelatha S, Padma PR. Protective mechanisms of Moringa oleifera against CCl(4)-induced oxidative stress in precision-cut liver slices. Forsch Komplementmed. 2010;17(4):189-194.
  8. Atawodi SE, Atawodi JC, Idakwo GA, et al. Evaluation of the polyphenol content and antioxidant properties of methanol extracts of the leaves, stem, and root barks of Moringa oleifera Lam. J Med Food. Jun 2010;13(3):710-716.
  9. Chumark P, Khunawat P, Sanvarinda Y, et al. The in vitro and ex vivo antioxidant properties, hypolipidaemic and antiatherosclerotic activities of water extract of Moringa oleifera Lam. leaves. J Ethnopharmacol. Mar 28 2008;116(3):439-446.
  10. Chattopadhyay S, Maiti S, Maji G, et al. Protective Role of Moringa oleifera (Sajina) Seed on Arsenic-Induced Hepatocellular Degeneration in Female Albino Rats. Biol Trace Elem Res. 2011 Aug;142(2):200-12.
  11. Fakurazi S, Hairuszah I, Nanthini U. Moringa oleifera Lam prevents acetaminophen induced liver injury through restoration of glutathione level. Food Chem Toxicol. Aug 2008;46(8):2611-2615.
  12. Jaiswal D, Kumar Rai P, Kumar A, Mehta S, Watal G. Effect of Moringa oleifera Lam. leaves aqueous extract therapy on hyperglycemic rats. J Ethnopharmacol. Jun 25 2009;123(3):392-396.
  13. Cheenpracha S, Park EJ, Yoshida WY, et al. Potential anti-inflammatory phenolic glycosides from the medicinal plant Moringa oleifera fruits. Bioorg Med Chem. Sep 1 2010;18(17):6598-6602.
  14. Sashidhara KV, Rosaiah JN, Tyagi E, et al. Rare dipeptide and urea derivatives from roots of Moringa oleifera as potential anti-inflammatory and antinociceptive agents. Eur J Med Chem. Jan 2009;44(1):432-436.
  15. Mahajan SG, Mehta AA. Immunosuppressive activity of ethanolic extract of seeds of Moringa oleifera Lam. in experimental immune inflammation. J Ethnopharmacol. Jul 6 2010;130(1):183-186.
  16. Mahajan SG, Mehta AA. Inhibitory Action of Ethanolic Extract of Seeds of Moringa oleifera Lam. On Systemic and Local Anaphylaxis.J Immunotoxicol. Oct 2007;4(4):287-294.
  17. Mahajan SG, Banerjee A, Chauhan BF, et al. Inhibitory effect of n-butanol fraction of Moringa oleifera Lam. seeds on ovalbumin-induced airway inflammation in a guinea pig model of asthma. Int J Toxicol. Nov-Dec 2009;28(6):519-527.
  18. Rahman MM, Akhter S, Jamal MA, et al. Control of coliform bacteria detected from diarrhea associated patients by extracts of Moringa oleifera. Nepal Med Coll J. Mar 2010;12(1):12-19.
  19. Firth J, Balraj V, Muliyil J, et al. Point-of-use interventions to decrease contamination of drinking water: a randomized, controlled pilot study on efficacy, effectiveness, and acceptability of closed containers, Moringa oleifera, and in-home chlorination in rural South India. Am J Trop Med Hyg. May 2010;82(5):759-765.
  20. Ayanbimpe GM, Ojo TK, Afolabi E, Opara F, Orsaah S, Ojerinde OS. Evaluation of extracts of Jatropha curcas and Moringa oleifera in culture media for selective inhibition of saprophytic fungal contaminants. J Clin Lab Anal. 2009;23(3):161-164.
  21. Lipipun V, Kurokawa M, Suttisri R, et al. Efficacy of Thai medicinal plant extracts against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res. Nov 2003;60(3):175-180.
  22. Mazumder UK, Gupta M, Chakrabarti S, Pal D. Evaluation of hematological and hepatorenal functions of methanolic extract of Moringa oleifera Lam. root treated mice. Indian J Exp Biol. Jun 1999;37(6):612-614.
  23. Karadi RV, Gadge NB, Alagawadi KR, Savadi RV. Effect of Moringa oleifera Lam. root-wood on ethylene glycol induced urolithiasis in rats. J Ethnopharmacol. Apr 21 2006;105(1-2):306-311.
  24. Debnath S, Biswas D, Ray K, Guha D. Moringa oleifera induced potentiation of serotonin release by 5-HT(3) receptors in experimental ulcer model. Phytomedicine. 2011 Jan 15;18(2-3):91-5.
  25. Duangjai A, Ingkaninan K, Limpeanchob N. Potential mechanisms of hypocholesterolaemic effect of Thai spices/dietary extracts. Nat Prod Res. Jul 8 2010:1-12.
  26. Shukla S, Mathur R, Prakash AO. Biochemical and physiological alterations in female reproductive organs of cyclic rats treated with aqueous extract of Moringa oleifera Lam. Acta Eur Fertil. Jul-Aug 1988;19(4):225-232.
  27. Prakash AO, Pathak S, Shukla S, Mathur R. Uterine histoarchitecture during pre and post-implantation periods of rats treated with aqueous extract of Moringa oleifera Lam. Acta Eur Fertil. Mar-Apr 1987;18(2):129-135.
  28. Shukla S, Mathur R, Prakash AO. Antifertility profile of the aqueous extract of Moringa oleifera roots. J Ethnopharmacol. Jan 1988;22(1):51-62.
  29. Ganguly R, Guha D. Alteration of brain monoamines & EEG wave pattern in rat model of Alzheimer’s disease & protection by Moringa oleifera. Indian J Med Res. Dec 2008;128(6):744-751.
  30. Rathi BS, Bodhankar SL, Baheti AM. Evaluation of aqueous leaves extract of Moringa oleifera Linn for wound healing in albino rats. Indian J Exp Biol. Nov 2006;44(11):898-901.
  31. Faizi S, Siddiqui BS, Saleem R, Siddiqui S, Aftab K, Gilani AH. Isolation and structure elucidation of new nitrile and mustard oil glycosides from Moringa oleifera and their effect on blood pressure. J Nat Prod. Sep 1994;57(9):1256-1261.
  32. Villasenor IM, Lim-Sylianco CY, Dayrit F. Mutagens from roasted seeds of Moringa oleifera. Mutat Res. Oct 1989;224(2):209-212.
  33. Villasenor IM, Finch P, Lim-Sylianco CY, Dayrit F. Structure of a mutagen from roasted seeds of Moringa oleifera. Carcinogenesis. Jun 1989;10(6):1085-1087.
  34. Pal A, Bawankule DU, Darokar MP, et al. Influence of Moringa oleifera on pharmacokinetic disposition of rifampicin using HPLC-PDA method: a pre-clinical study. Biomed Chromatogr. 2011 Jun;25(6):641-5.
  35. Monera TG, Wolfe AR, Maponga CC, Benet LZ, Guglielmo J. Moringa oleifera leaf extracts inhibit 6beta-hydroxylation of testosterone by CYP3A4. J Infect Dev Ctries. 2008;2(5):379-383.
  36. Ghiridhari VVA, Malhati D, Geetha K. Anti-diabetic properties of drumstick (Moringa oleifera) leaf tablets. Int J Health Nutr. 2011;2:1-5.
  37. Adejumo OE, Kolapo AL, Folarin AO. Moringa oleifera Lam. (Moringaceae) grown in Nigeria: In vitro antisickling activity on deoxygenated erythrocyte cells. J Pharm Bioallied Sci. Apr 2012;4(2):118-122.
  38. Nambiar VS, Guin P, Parnami S, et al. Impact of antioxidants from drum stick leaves on the lipid profile of hyperlipidemics. J Herb Med Toxicol. 2010;4:165–172.
  39. Asare GA, Gyan B, Bugyei K, et al. Toxicity potentials of the nutraceutical Moringa oleifera at supra-supplementation levels. J Ethnopharmacol. Jan 6 2012;139(1):265-272.
  40. Oyagbemi AA, Omobowale TO, Azeez IO, et al. Toxicological evaluations of methanolic extract of Moringa oleifera leaves in liver and kidney of male Wistar rats. J Basic Clin Physiol Pharmacol. 2013 Mar 18:1-6.
  41. Tang Y, Choi EJ, Han WC, et al. Moringa oleifera from Cambodia Ameliorates Oxidative Stress, Hyperglycemia, and Kidney Dysfunction in Type 2 Diabetic Mice. J Med Food. 2017 May;20(5):502-510.
  42. Dzotam JK, Touani FK, Kuete V. Antibacterial and antibiotic-modifying activities of three food plants (Xanthosoma mafaffa Lam., Moringa oleifera (L.) Schott and Passiflora edulis Sims) against multidrug-resistant (MDR) Gram-negative bacteria. BMC Complement Altern Med. 2016 Jan 11;16:9.
  43. Kim Y, Wu AG, Jaja-Chimedza A, Graf BL, Waterman C, Verzi MP, Raskin I. Isothiocyanate-enriched moringa seed extract alleviates ulcerative colitis symptoms in mice. PLoS One. 2017 Sep 18;12(9):e0184709.
  44. Anthanont P, Lumlerdkij N, Akarasereenont P, Vannasaeng S, Sriwijitkamol A. Moringa Oleifera Leaf Increases Insulin Secretion after Single Dose Administration: A Preliminary Study in Healthy Subjects. J Med Assoc Thai. 2016 Mar;99(3):308-13.
  45. Tshingani K, Donnen P, Mukumbi H, Duez P, Dramaix-Wilmet M. Impact of Moringa oleifera lam. Leaf powder supplementation versus nutritional counseling on the body mass index and immune response of HIV patients on antiretroviral therapy: a single-blind randomized control trial. BMC Complement Altern Med. 2017 Aug 22;17(1):420.
  46. Berkovich L, Earon G, Ron I, Rimmon A, Vexler A, Lev-Ari S. Moringa Oleifera aqueous leaf extract down-regulates nuclear factor-kappaB and increases cytotoxic effect of chemotherapy in pancreatic cancer cells. BMC Complement Altern Med. 2013 Aug 19;13:212.
  47. Olurishe C, Kwanashie H, Zezi A, Danjuma N, Mohammed B. Chronic administration of ethanol leaf extract of Moringa oleifera Lam. (Moringaceae) may compromise glycaemic efficacy of Sitagliptin with no significant effect in retinopathy in a diabetic rat model. J Ethnopharmacol. 2016 Dec 24;194:895-903.
  48. Nova E, Redondo-Useros N, Martínez-García RM, et al. Potential of Moringa oleifera to Improve Glucose Control for the Prevention of Diabetes and Related Metabolic Alterations: A Systematic Review of Animal and Human Studies. Nutrients. Jul 10 2020;12(7).
  49. Witharana E, Wijetunga W, Wijesinghe SKJ. Stevens - Johnson syndrome (SJS) following Murunga leaf (Moringa oleifera) consumption. Ceylon Med J. Dec 31 2018;63(4):188-189.
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