Common Names

  • Lada
  • Indian mulberry
  • Nono
  • Hog apple

For Patients & Caregivers

Noni showed anticancer effects in laboratory studies. It is being studied in cancer patients.

The juice of the noni fruit has been traditionally used in Polynesian cultures as an anticancer agent. Scientists have isolated a fraction from noni juice that is rich in complex sugars. This fraction, alone and in conjunction with chemotherapy drugs, is able to increase the survival of laboratory mice that have been implanted with lung cancer. Scientists are unsure exactly how noni exerts this effect, but observe that it enhances certain aspects of the immune system. Furthermore, noni juice acts as an antioxidant and slows the transformation of normal cells to cancer cells in animal studies.

  • To treat cancer
    Laboratory studies in animals show that noni extracts can increase the survival of mice implanted with lung cancer, both when used alone and with chemotherapy drugs. There is no proof from clinical trials that the same effect occurs in humans, but a preliminary study is underway.
  • To treat chronic fatigue syndrome
    No scientific evidence supports this use.
  • To treat diabetes
    No scientific evidence supports this use. Noni is a fruit that is rich in complex sugars and therefore may worsen high blood sugar levels.
  • To lower high blood pressure
    No scientific evidence supports this use.
  • As an immune stimulant
    Laboratory studies show that noni juice enhances certain aspects of the immune system, but these results are not always transferable to the human body. There is no proof from clinical trials that these effects occur in humans.
  • To manage menstrual cramps
    No scientific evidence supports this use.
  • As an analgesic
    One study in laboratory mice supports this use, but there is no proof from clinical trials that the same effect occurs in humans.
  • You have renal insufficiency: Noni is high in potassium content.
  • You have diabetes: Noni juice has a high sugar content.
  • You are taking potassium-sparing diuretics, angiotensin converting enzyme (ACE) inhibitors, or angiotensin receptor blockers.
  • You are undergoing chemotherapy or radiation therapy: Noni has antioxidant effects and can interfere with treatment.
  • You are taking blood-thinning medications such as coumadin: Noni juice can reduce their effectiveness.
  • You are taking cytochrome P450 3A4 substrate drugs: Noni may reduce effects or increase side-effects of these drugs.
  • You are taking UGT (Uridine 5’-diphospho-glucuronosyltransferase) substrate drugs: Noni may increase the risk of side effects of these drugs.
  • Constipation

Case reports

  • Kidney failure and dangerously high potassium levels in the blood resulting from noni juice use.
  • Liver failure in a 29-year-old man with prior toxic hepatitis, following ingestion of 1.5 litres of noni juice over a period of 3 weeks. He recovered completely after liver transplantation.
  • Acute hepatitis in a 62-year-old woman after consuming 2 litres of noni juice over 3 months. She recovered following cessation of noni juice intake.
  • Coumadin resistance in a 41-year-old woman following concurrent intake of noni juice. Symptoms improved after treatment and discontinuing noni juice.

However, a company-sponsored study showed that dose-related adverse effects are minimal in a noni product.

Back to top

For Healthcare Professionals

Morinda citrifolia

Noni is an evergreen plant found throughout Polynesia. The plant bears fleshy yellowish-white fruit and is used in traditional medicine for wound healing, infections, diarrhea, skin conditions, and as a tonic. It is also cultivated in Hawaii and other Polynesian islands and is marketed worldwide as Noni. Fresh or fermented juices are available as drinks while capsules, pills, and powders are sold as dietary supplements.

Over the last two decades, products containing Noni have been heavily promoted for immunostimulation, chronic fatigue syndrome, hypertension, and cancer treatment via network marketing schemes. The FDA issued a warning letter to an Internet distributor of noni juice for presenting misleading claims of health benefits (1).

In vitro and animal studies suggest that the plant extracts have antifungal (14), antitumor, and immunomodulatory (3) (7) (8) (17) (18) properties. Noni also inhibits low-density-lipoprotein oxidation and may be useful in preventing arteriosclerosis (15). Glycosides and other constituents isolated from the fruits and leaves have demonstrated antioxidant effects (12) (13). In addition, a high concentration (>5%) of noni juice was shown to have antiangiogenic properties in an ex vivo assay (16).

In human studies, a noni extract was shown to be effective in reducing incidence of early postoperative nausea (29). Consumption of noni juice alleviated cigarette smoke-induced dyslipidemia (30). A phase I study of noni in cancer patients has been completed at the University of Hawaii’s Cancer Research Center; findings are yet to be published (11).

Morinda citrifolia should not be confused with Morinda officinalis, also known as Ba Ji Tian, commonly used in Chinese medicine.

  • Cancer treatment
  • Chronic fatigue syndrome
  • Diabetes
  • Health maintenance
  • Hypertension
  • Immunostimulation
  • Menstrual cramps
  • Pain

Glycosides isolated from noni juice inhibit AP-1 transactivation and cell transformation in mouse epidermal JB6 cell lines (2). In addition, noni juice exhibited antioxidant effects by reducing aromatic DNA adducts (5) (19). In animal models, an aqueous extract of noni root produced a central analgesic effect that was antagonized by naloxone  (6).

When combined with suboptimal doses of certain chemotherapy agents, polysaccharides from noni improved survival time and curative effects (4). The apoptotic effects of noni are thought to be medicated via upregulation of p53 and proapoptotic Bax proteins, as well as downregulation of the antiapoptotic Bcl-2, Bcl-XL proteins and survivin. Increase in caspase 9 and 3 was also reported, which suggests involvement of the intrinsic mitochondrial pathway (31).

  • Patients with renal insufficiency should consume noni juice with caution due to high potassium content (7).
  • Patients with diabetes should consume noni juice with caution due to high sugar content.

Case reports

  • Hepatotoxicity, some acute, following consumption of noni juice products (9) (10) (22) (23) (24) (26).
  • Hyperkalemia (7) due to high potassium content.
  • Resistance to coumadin in a 41-year-old woman following concurrent intake of noni juice. Symptoms improved after treatment and discontinuing noni juice (25)
  • However, a company-sponsored study suggests that dose-related adverse effects are minimal in a noni product (20).
  • Chemotherapy or radiation therapy: The antioxidant effects of noni products may decrease the activity of some chemotherapeutic agents (21) or radiation therapy.
  • Coumadin: Noni juice was reported to antagonize the effects of coumadin (25).
  • Cytochrome P450 substrate drugs: An in vitro study finds noni juice induces CYP 3A4, 2C8, 2C9, and 2D6, and may decrease the therapeutic effects of substrate drugs (21). Another study shows that noni juice inhibits CYP 3A4 enzymes (27). Duration of exposure may account for these differences.
  • UGT (Uridine 5’-diphospho-glucuronosyltransferase) substrate drugs: Noni modulates UGT enzymes in vitro and can increase the side effects of drugs metabolized by them (28).

  1. FDA warning letter. Accessed June 6,2013.

  2. Wang MY, Su C. Cancer preventative effect of Morinda citrifolia (noni). Ann N Y Acad Sci 2001;952:161-8.

  3. Younos C, et al. Analgesic and behavioural effects of Morinda citrifolia. Planta Med 1990;56:430-4.

  4. Mueller BA, et al. Noni juice (Morinda citrifolia): hidden potential for hyperkalemia? Am J Kidney Dis 2000;35:310-2.

  5. Stadlbauer V, et al. Hepatotoxicity of NONI juice: Report of two cases. World J Gastroenterol. 2005;11(30):4758-60.

  6. Millionig G, Stadlmann S, Vogel W. Herbal hepatotoxicity: acute hepatitis caused by a Noni preparation (Morinda citrifolia). Eur J Gastroenterol Hepatol. 2005; 17(4):445-7.

  7. Study of Noni in Cancer Patients. Accessed June 6, 2013.

  8. Arpornsuwan T, Punjanon T. Tumor cell-selective antiproliferative effect of the extract from Morinda citrifolia fruits. Phytother Res 2006; 20(6):515-7.

  9. Wang MY, Peng L, Lutfiyya MN, et al. Morinda citrifolia (noni) reduces cancer risk in current smokers by decreasing aromatic DNA adducts. Nutr Cancer. 2009;61(5):634-9.

  10. 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.

  11. Santiago K, Gaikwad A, Coffer L, et al. Evaluation of the Hepatic Metabolism and Antitumor Activity of Noni Juice ( Morinda citrifolia L.) in Combination with Chemotherapy. Journal of the Society for Integrative Oncology. Vol 8, No 3 (Summer), 2010: p. 89.

  12. Millonig G, Stadlmann S, Vogel W. Herbal hepatotoxicity: acute hepatitis caused by a Noni preparation (Morinda citrifolia). Eur J Gastroenterol Hepatol. 2005 Apr;17(4):445-7.

  13. Stadlbauer V, Weiss S, Payer F, Stauber RE. Herbal does not at all mean innocuous: the sixth case of hepatotoxicity associated with morinda citrifolia (noni). Am J Gastroenterol. 2008 Sep;103(9):2406-7.

  14. Carr ME, Klotz J, Bergeron M. Coumadin resistance and the vitamin supplement “Noni”. Am J Hematol. 2004 Sep;77(1):103.

  15. Yu EL, Sivagnanam M, Ellis L, Huang JS. Acute hepatotoxicity after ingestion of Morinda citrifolia (Noni Berry) juice in a 14-year-old boy. J Pediatr Gastroenterol Nutr. 2011 Feb;52(2):222-4.

  16. Engdal S, Nilsen OG. In vitro inhibition of CYP3A4 by herbal remedies frequently used by cancer patients. Phytother Res. 2009 Jul;23(7):906-12.

  17. Prapaitrakool S, Itharat A. Morinda citrifolia Linn. for prevention of postoperative nausea and vomiting. J Med Assoc Thai. 2010 Dec;93 Suppl 7:S204-9.

  18. Wang MY, Peng L, Weidenbacher-Hoper V, et al. Noni juice improves serum lipid profiles and other risk markers in cigarette smokers. ScientificWorldJournal. 2012;2012:594657.

  19. Gupta RK, Banerjee A, Pathak S, Sharma C, Singh N. Induction of mitochondrial-mediated apoptosis by Morinda citrifolia (Noni) in human cervical cancer cells. Asian Pac J Cancer Prev. 2013;14(1):237-42.

Back to top
Back to top
Email your questions and comments to

Last Updated