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Noni juice for cancer and more.

Use: Traditional and Modern

Morinda citrifolia (noni) is thought to have been one of the most important plants in traditional Polynesian medicine, possibly originating in Southeast Asia and being distributed throughout the islands of the South Seas by ancient seafaring islanders.

William McClatchey, Ph.D., of the department of botany and the Cancer Research Center of Hawaii at the University of Hawaii, Honolulu, spent many years in the remote Pacific islands interviewing elderly traditional healers about M. citrifolia and other medicinal plants. Noni grows wild in many areas of the Pacific islands. On the Polynesian island of Rotuma, where residents had a subsistence-based society in which traditional medicine was the primary health care system, Dr. McClatchey found noni to be the most commonly used herbal remedy.

He chronicled many detailed protocols in which various parts of the plant are used for specific ailments. For example, for sores in the mouth, immature fruits are crushed and mixed with coconut oil. This mixture is placed in a coconut-fiber mesh cloth, wrapped in a banana leaf, and heated over a fire. The cloth is then squeezed, and the resulting warm solution is drunk. For fractures or dislocations, the leaves are wrapped and tied over the bone after it is set but before splints are applied (Int. Cancer Ther. 2002;1:1,10-20).

During the past 2 decades, interest in noni's commercial production and marketing has increased dramatically, and today it is the biggest-selling botanical product in the world. Much of the interest originated with the publication of a report in the Pacific Tropical Botanical Garden Bulletin (1985;15:10-4). This report, by Ralph Heinicke, Ph.D., then a biochemist with the Dole Pineapple Co, and the University of Hawaii, identified an alkaloid that he named "xeronine" as the pharmacologically active component in noni; Dr. Heinicke hypothesized that xeronine could modify the molecular structure of improperly functioning proteins.

Dr. McClatchey described this report as "outrageous," writing, "It is interesting that this seemingly biochemical report is published in the bulletin of a botanical garden, because it may have been better published in the Journal of Irreproducible Results."

Dr. McClatchey's criticisms of Dr. Heinicke's report center on the fact that no chemical structure is given, or has subsequently been found, for previously undescribed xeronine.

Research Thus Far

Investigators have identified several antibacterial, antiviral, anthelmintic, and antitumor effects of noni extracts. Among the claims made for noni today are potential benefits in lupus, diabetes, hypertension, drug addiction, AIDS, and cancer. Noni is also sold as a wellness drink.

One group of researchers at the University of Hawaii reported that the addition of noni to standard chemotherapeutic treatment with doxorubicin, cisplatin, 5-fluorouracil, and vincristine in the Lewis lung carcinoma mouse model resulted in the stimulation of multiple mediators, including tumor necrosis factor-[alpha], various interleukins, and nitric oxide, as well as improved survival time (Phytother. Res. 1999;13:380-7).

Noni juice has also been shown to be protective against carcinogen-induced DNA damage in early breast cancer in animal models and, in one small study, to lower plasma levels of lipid peroxides and superoxide anion radicals in cigarette smokers (Acta Pharmacol. Sin. 2002;23:1127-41). A phase I study, sponsored by the National Center for Complementary and Alternative Medicine and conducted at the University of Hawaii Cancer Research Center, is currently enrolling patients.

The Liver Controversy

In 2005 three cases of hepatotoxicity possibly associated with the use of noni were reported from Austria. In one case, a 29-year-old man presented with acute hepatitis following an upper respiratory tract infection treated with acetaminophen. This resolved over a period of 3 months, but a year later he was readmitted with acute liver failure. For the previous 3 weeks, he had ingested 1.5 L of noni juice each day and had also been taking a Chinese herbal mix. He ultimately required two liver transplants (World J. Gastroenterol. 2005;11:4758-60).

The authors proposed that the most likely hepatotoxic components of noni were anthraquinones that may produce oxygen-de-rived free radicals that deplete intracellular glutathione, decrease mitochondrial membrane potential, and induce cell death.

The second case was a 62-year-old woman who presented with vomiting and diarrhea. She had been ingesting noni juice, and a liver biopsy showed evidence of an idiosyncratic drug reaction. The third case was a 45-year-old man with highly elevated transaminase levels who had a 3-week history of noni ingestion. These two patients recovered without incident after they stopped drinking noni (Eur. J. Gastroenterol. Hepatol. 2005;17:445-7).

In a letter to the editor of the World Journal of Gastroenterology, researchers from Tahitian Noni International Inc. and the department of toxicity at Universitat Hamburg (Germany) responded to these case reports. They described an unpublished study that included 96 subjects who were given placebo or one of three doses of Tahitian Noni juice (the proprietary brand involved in two of the case reports) for 28 days.

Measurements of liver function were evaluated, along with multiple blood chemistries, urinalyses, and vital signs. The researchers reported that all values were well within the range of normal (World J. Gastroenterol. 2006;12:3616-9).

They rejected the hypothesis that anthraquinones in noni were the cause of toxicity and stated that only a "minute" quantity of these compounds is present in the fruit. They also noted that all anthraquinones do not have the same structure or effects, and that the specific compounds found in noni cannot undergo reduction reactions to form hepatotoxic anthrone radicals.


* Juice of the Polynesian plant noni is popular for several therapeutic and prophylactic indications, including cancer.

* Little scientific evidence exists to support the use of noni, and hepatotoxicity may be a concern.
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Author:Walsh, Nancy
Publication:Internal Medicine News
Geographic Code:1USA
Date:May 1, 2007
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