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What does the Physician desk guide say about NONI?

Female
Female
asked Jan 20, 2011 at 08:30AM in General Medicine
9 Answers
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  • 0
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    answered Jan 20, 2011 at 10:16PM
    Noni juice (Morinda citrifolia L) is popular folk remedy and drink in the Caribbean and Pacific island nations and its health benefit claims cover a wide spectrum of human diseases. Most of these health claims are untested and unproven and are based on private testimonials of zero value Noni has many of documented cases of toxicity associated with its use.
  • 1
    Votes
    answered Jan 21, 2011 at 09:10AM
    While Dr. Maggon mentions "documented cases of toxicity" associated with the use of Noni berry juice, I am unaware of any of that. In fact it is clear that this fruit is a staple of the diet of the islanders in the regions of the World where it grows, and there are no reports of which I am aware, that they suffer any toxic effects from consuming it. On the positive side, there are certainly high levels of antioxidants and other beneficial substances in Noni juice, just as there are in many other fruit juices, like Pomegranate juice which all may have some benefits in terms of prevention of coronary artery disease. It is true though, that much research remains to be done to prove any of these claims. If anyone has actual references to negative toxicity studies on noni juice, or any other fruit juice in this category, I would love to review them.
  • 0
    Votes
    answered Jan 21, 2011 at 10:43PM
    Stephan,

    Thanks for your comments. The documented cases of Noni toxicity when searched in data bases gave the following results

    Pub Med 17
    Scholar 3260

    Searches on the ScienceDirect and Web of Science can provide you with a other list of published papers. The FDA site collects data on the reported adverse effects linked to Noni. FDA considers all heath claims as unproven or not backed by clinical evidence and has taken legal action against firms in the US promoting Noni.
  • 1
    Votes
    answered Jan 22, 2011 at 12:25PM
    Krishan - Thanks for the references. I certainly did look into this. It seems you are correct that there were some concerns about hepatotoxicity. But from all the studies I reviewed on Pubmed (abt 15 or so) the results showed there was none discovered or provable. Two studies looked at rat embryos and only one of those appears to show possibly "delayed ossification". The other reported no dangers at all. Several more seemed to report that Noni juice has hepato-PROTECTIVE value, and others were looking at angioneogenesis, but I saw no study that supported a significant provable anticancer benefit.
    Here are the studies I did think were significant in this argument:

    PUBMED.....................................................- FINDING
    http://www.ncbi.nlm.nih.gov/pubmed/19797868 - no liver toxicity
    http://www.ncbi.nlm.nih.gov/pubmed/19043286 - no danger to fetus
    http://www.ncbi.nlm.nih.gov/pubmed/18654853 - hepato protective effects!
    http://www.ncbi.nlm.nih.gov/pubmed/20038450 - MAY have cause delayed ossification in RAT embryos

    In short; it seems there is really no good evidence that NONI juice is toxic to the liver, or kidneys, but for the present time, I would certainly recommend that pregnant women DO NOT consume it, just to remain on the safe side, though any mutagenic or other negative issues are not yet proved.
    It still does appear from what I can glean from all this, that the cardiovascular benefits probably outweigh the dearth of negative outcome studies. Thanks for the challenge.
  • 0
    Votes
    answered Jan 22, 2011 at 10:30PM
    Stephan,

    Thanks once again for your review of the studies. I did a confidential unpublished review of Noni a few years ago and had access to some unpublished studies in France which showed liver enzyme elevation in healthy subjects (early indicator of hepatotoxicity) and other some safety issues. It is very difficult to establish a definitive drug-adverse event relationship. Under current rules, all adverse events are considered drug related unless proven otherwise. The burden of proof of safety and efficacy in double blind clinical studies in large number of subjects/patients rests with the producers and promoters of Noni and is lacking at present. Commercialization of Noni as a food supplement with general health claims keeps it out of the oversight of the FDA and EMA and is a highly profitable business.
  • 2
    Votes
    answered Jan 22, 2011 at 10:49PM
    That's true of all food supplements. But, at the same time I am no fan of letting the FDA control all the vitamin and food supplement industry. We'd become like Europe, where you can;t buy melatonin without a prescription. Where's the happy medium?
  • 0
    Votes
    answered Jan 24, 2011 at 11:46AM
    In Europe there were problems with supplements contaminated with pesticides, microbes, mycotoxins, heavy metals as well animal body parts, so urgent action was required at the EC level. Clinical testing resulted in market withdrawal of several unsafe and ineffective products. So no oversight leave consumers open to exploitation, so may be a mid way to protect consumers will do?
  • 1
    Votes
    answered Jan 24, 2011 at 12:58PM
    Clearly some oversight is required to assure purity and even before that, cleanliness of manufacturing processes. It would seem that licensing the facilities which produce the supplements by way of cleanliness laws is a real good middle ground. But, I understand that there are ISO standards for which labs can apply, and public education should improve as to which to look for on a lable of a product intended for human consumption.

    In my opinion there should also be some set of standards for human absorbability of contents; i.e. at the moment only the FTC oversees what goes into such products. Thus, if there are iron filings in a breakfast cereal, the mfg. can say it is "fortified with iron". The public has no way to understand this kind of scam without sophisticated testing. How many studies were done on Vitamin C, with pure ascorbic acid? In nature we never get Vit C, without rutin, hesperidin and bioflavinoids, and absorption is severely affected when they are not present. Etc., etc. This goes on and on. I'm only getting started.
  • 1
    Votes
    answered May 05, 2011 at 05:37PM
    The oversight of nutritional products is very similar to that of foods. One difference, practically, is that supplements may be taken religiously every day, where a particular food, even if contaminated, may be eaten only occasionally. Therefore, safety of supplements is of interest. Consuming supplements that are manufactured to pharmaceutical GMP standards can be of value in increasing the probability of purity. Interestingly, in the U.S. the competition is causing more and more supplements to be manufactured that way, obviating the increased need for more regulation. Happily, this may result in increased safety in the industry.
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