Drug Profile

Background

Noni is the common name for Morinda citrifolia, the Indian mulberry or cheese fruit tree that grows wild on tropical islands such as Samoa, Tonga, Tahiti, and Hawaii. The noni plant is a small evergreen tree found in coastal areas and in forested areas as high as 1,300 feet above sea level. It has large, bright green elliptical leaves and bears a fruit that changes from green to yellow to white as it matures. The bark is used to make a reddish purple and brown dye that is used in batik. But it is the fruit that has attracted most attention. Its promotors claim that noni has been used as an herbal remedy for over 2,000 years in Polynesia.[1],[2] Because it has a foul odor and taste, it is typically mixed with grape or other juices and consumed as a liquid. Hair care products, diet aids, and skin care lotions containing noni are also available.

Many of noni’s claims rest on the work of Dr. Ralph Heineke, who claims that noni contains proxeronine, which is converted to xeronine in the body. It is xeronine that is claimed to cause the multiple health benefits assumed by noni supporters. There is no scientific proof for this hypothesis. More recently, the primary proponent of noni has been Dr. Neil Solomon, a former health commissioner of Maryland, who surrendered his license to practice medicine in Maryland after several of his female patients accused him of sexual misconduct.[3] He has authored a number of books with titles such as The Noni Phenomenon and Noni Juice the Tropical Fruit with 101 Medicinal Uses.[4]

Both Dr. Heineke and Dr. Solomon endorse the noni product of Tahitian Noni International,[5],[6] which is the market leader. The company markets its product as “An exotic health discovery from French Polynesia,” and its label features a bare-chested local male with a mohawk haircut eating the fruit.

Claimed Uses

Among the supplements reviewed for this web site, noni bears the distinction of having the broadest claims and the weakest scientific evidence. Although a reference to a randomized, controlled trial appears in one published article,[2] we have not been able to locate a published version of this trial. The claims for noni efficacy are thus made on the basis of test tube studies,[7],[2] which do not even remotely approach the standards for approval of the FDA, and Dr. Solomon’s book.

The book, which describes noni as having “miraculous health benefits,” lists noni’s main attributes as increasing body energy, alleviating pain, inhibiting cancer and precancer, acting as an anti-inflammatory and antihistamine, regulating sleep, temperature, and mood, and its antibacterial properties.[8] Supporting evidence for these claims appears to rest in part on a review of effectiveness claims made by “over 15,000” noni patients. Dr. Solomon reports that from 51 percent (multiple sclerosis) to 90 percent (increasing energy) of patients derived benefit from noni. He adds: “The majority of Noni users who did not get optimal results failed to do so because they took a lesser dose and/or took it a lesser amount of time than recommended.”[8] Collecting anecdotes from self-selected users does not remotely approach any reasonable standard of efficacy.

Interactions with Other Drugs

No interactions with other drugs have been reported, but this has not been studied formally.

Adverse Effects

Noni juice contains potassium at levels comparable to those found in orange juice and so the product should not be used in patients with kidney disease.[9]

Conclusion

Noni is a newly popular herbal product about which little is known and for which acceptable research absent. There is no scientific evidence for the wide array of health claims made for the product.