Noni (Garrett Ozborn , University of Mississippi Coll School ege of Pharmacy

Noni

(Morinda citrifolia L.)

Common Names:

Morinda, Indian mulberry, hog apple, canarywood, awltree, ice leaf History:

Noni is a fruit that grows from trees of the Morinda citrifolia L.species. These trees grow among the lava flows of Polynesia, India, Australia, the Pacific Islands, and Southeast Asia. While all parts of the plant show some effect, the fruit appears to have the most use in traditional medicine. Although the fruit produces a strong, cheese-like smell and the juice is quite bitter, the fruit is still a staple food in many cultures and has been used in traditional medicine for over 2000 years. The fruit is rich in vitamins, antioxidants, and other valuable nutrients, and has shown both immune-stimulating and tumor-fighting properties. Today, the fruit juice and its extracts are used in dietary supplements that claim to promote the immune system and help with a variety of common disorders.

http://pbio209.pbworks.com/w/page/11342399/Gupta%2C%20N%2 0-%20Noni%20tree https://en.wikipedia.org/wiki/Morinda_citrifolia

Common Uses:

While some cultures still consume the fruit in their diets, extracts and juices from the fruit have been used in natural healing formulations to treat a variety of conditions, including diabetes, high blood pressure, dyslipidemia, constipation, aging, anxiety, depression, cancer, tumor, burns, aches, arthritis, and infections. Dietary supplements containing Noni are promoted to prevent cancer and infections, treat hypertension, promote weight loss, lower cholesterol, and help manage other conditions.

Dosage Forms:

Noni is supplied in its juice form and can be mixed with other juices to help the flavor. Noni extract is also supplied as immediate and extended-release tablets of 30, 60, or 90 milligrams. Additionally, Noni extract can be found as an ingredient in a variety of dietary supplements, essential oils, and topical formulations. Typical Dosing:

Typical dosing regimens for therapeutic effect include up to 600 milligrams of extract or 30750 milliliters of juice per day

https://www.mauimedicinal.com/collections/noni Pharmacology:

Noni has had several proposed mechanisms of action. Some studies have shown results that suggest it produces its metabolic and immunomodulatory effects by acting on gene transcription factors such as the Nrf2 pathway that control expression of antioxidant enzymes. Other students have suggested that Noni promotes Nitric Oxide release and modulates the glucagon-like peptide-1 receptor to produce its antihypertensive effects. Safety:

Noni is generally considered safe when taken orally or administered topically. Few side effects have been reported in Noni studies. There have been cases of liver toxicity in some users, but the causality of the toxicity is unclear. Adverse Effects/Toxicities:

While generally safe, Noni studies have reported common side effects such as diarrhea and, due to the juice’s high potassium levels, elevated serum potassium. Additionally, though whether or not Noni causes this toxicity is unclear, there have been reports of acute hepatitis and liver toxicity in Noni studies. It is recommended that patients not take Noni with drugs that could further raise serum potassium, particularly potassium-sparing diuretics. Additionally, strong CYP3A4 inducers will reduce the efficacy of Noni products.

Interactions:

Professional Opinion:

In my professional opinion, Noni possesses the potential for many positive therapeutic effects. While there are few studies to support the efficacy of these products, I would be comfortable with patients trying these products in addition to prescription treatment in mild to moderate cases in the absence of any kidney or liver problems. I would recommend that patients inform their doctor and pharmacist that they take this product in order to monitor for adverse effects and interactions. ~ G. Ozborn References:

Cunha JP. Noni juice: Herbals, uses, side effects, dosages, interactions, warnings. RxList. https://www.rxlist.com/consumer_noni_juice/drugscondition.htm. Published August 19, 2021. Accessed March 3, 2022. Noni uses, benefits & side effects - drugs.com herbal database. Drugs.com. https://www.drugs.com/npc/noni.html. Accessed Noni. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/noni. Accessed March 3, 2022. March 3, 2022. Yoshitomi H, Zhou J, Nishigaki T, et al. Morinda citrifolia ( noni ) fruit juice promotes vascular endothelium function in hypertension via glucagon‐like peptide‐1 receptor‐camkkβ‐ampk‐enos pathway. Phytotherapy Research. 2020;34(9):2341-2350. doi:10.1002/ptr.6685 Zhang K, Meng J, Li X, et al. Noni ( Morinda citrifolia L.) wine prevents the oxidative stress and obesity in mice induced by high‐Fat Diet. Journal of Food Biochemistry. 2020;44(11). doi:10.1111/jfbc.13460