Moringa oleifera

• How It Works

  Moringa oleifera (MO) is commonly used for a variety of conditions, but studies in humans are limited.

  MO is an edible plant cultivated worldwide. The leaves and seed pods are consumed as food. Extracts from its leaves, bark, seed pods, and pulp are also used in a variety of folk medicine treatments, either given by mouth or as a topical agent applied to the skin. Products derived from the herb are used to treat a variety of conditions including asthma, diabetes, ulcers, infections, and cancer. However, data on MO is limited and it has not been studied in humans as a cancer treatment.

• Purported Uses
  • Antibacterial
    The leaf and seed extracts of MO were shown to stop the growth of bacteria that cause diarrhea in lab studies. Human data are lacking.
  • Antifungal
    MO extracts have been shown to stop the growth of fungi in lab experiments. More studies are needed.
  • Anti-inflammatory
    The seed extract of MO and compounds isolated from its fruits have the ability to prevent inflammation. Further research is needed.
  • Diabetes
    MO can reduce blood glucose levels and may be a useful antidiabetic agent, but human studies have not been conducted.
  • Anti-ulcer
    Lab studies indicate that MO extracts can protect against stomach ulcers. More studies are needed.
  • Anticancer
    Lab and animal studies show that MO extracts have anticancer effects. Human data are lacking.
  • Elevated lipid concentrations
    A small study showed a mild positive impact on the lipid profile of patients with hyperlipidemia.
• Patient Warnings
  • Although MO leaves are a part of the diet in some regions of the world, lab studies have indicated that parts of the plant, especially the bark and the pulp, may be harmful in large doses.
• Do Not Take If
  • You are taking drugs that are substrates of cytochrome P450, including CYP3A4: M. oleifera may increase the risk of side effects of these drugs.
  • You are taking the diabetes medication sitagliptin: MO can decrease the antihyperglycemic effects of sitagliptin.
  • You are pregnant: MO bark may cause contractions in the uterus, and has been used to induce abortion in some cases.
• Side Effects

  As studies in humans are limited, the following effects have been found in laboratory studies:

  • Alkaloids in MO can lower blood pressure and slow heart rate.
  • MO bark can cause uterine contractions.
  • Phenylacetonitrile isolated from roasted MO seeds can cause cell mutations.
  • MO extracts may have antifertility properties.
  • MO leaves increased the risk of liver and kidney damage in rats.
• Scientific Name

  Moringa oleifera

• Clinical Summary

  Moringa oleifera (MO) is an edible plant that is native to Asia and Africa and also cultivated around the world. Its leaves and seed pods are nutritious and widely consumed as food; the bark and root are thought to have medicinal properties and are employed in folk remedies. Products derived from the herb are used to treat a variety of conditions including asthma, diabetes, ulcers, infections, and cancer. In addition, the plant extracts are used in primitive water filtration systems to remove pollutants and algae ⁽¹⁾.

  In vitro and animal studies indicate that the leaf, seed, and root extracts of MO have anticancer ^(3) (4), hepatoprotective ⁽¹⁰⁾, hypoglycemic ^(12) (41), anti-inflammatory ^(13) (14), antibacterial ^{(18) (19) (42)}, antifungal ⁽²⁰⁾, antiviral ⁽²¹⁾, and antisickling ⁽³⁷⁾ and effects. They may also protect against Alzheimer’s disease ⁽²⁹⁾ and stomach ulcers ⁽²⁴⁾, help lower cholesterol levels ⁽²⁵⁾, promote wound healing ⁽³⁰⁾, and alleviate symptoms of ulcerative colitis ⁽⁴³⁾. An MO extract demonstrated antifertility effects in a murine model ⁽²⁸⁾.

  Clinical data are limited ⁽³⁶⁾, but preliminary findings show that MO exerts a small positive effect on lipid profiles ⁽³⁸⁾. An MO leaf powder increased insulin secretion in healthy subjects ⁽⁴⁴⁾, and improved nutritional status and intake of AIDS patients undergoing antiretroviral therapy ⁽⁴⁵⁾.

• Food Sources

  MO leaves are eaten in many parts of the tropics where the trees are found.

• Purported Uses
  • Antibacterial
  • Antifungal
  • Anti-inflammatory
  • Diabetes
  • Ulcers
  • Anticancer
• Mechanism of Action

  The antioxidant ^(7) (8), hypolipidemic, and antiatherosclerotic activities of MO are thought to help prevent cardiovascular diseases ⁽⁹⁾. It also showed hepatoprotective effects ⁽¹⁰⁾ and protected the liver from acetaminophen toxicity by maintaining glutathione level ⁽¹¹⁾. MO can reduce blood glucose levels as well, ⁽¹²⁾ which suggests hypoglycemic effects. The fiber content of the leaves can mediate quercetin-3-glucoside to improve glucose tolerance ⁽⁷⁾. In addition, phenolic glycosides from the fruit show anti-inflammatory effects by inhibiting nitric oxide ⁽¹³⁾. Dipeptide and urea derivatives from MO roots also have anti-inflammatory and antinociceptive effects and may benefit those with arthritis ⁽¹⁴⁾. The ethanolic seed extract may produce immunosuppressive and anti-inflammatory effects by inhibiting leukocytes and splenocytes ⁽¹⁵⁾ as well as histamine release from mast cells ⁽¹⁶⁾. It also reduced airway inflammation suggesting it may benefit those with asthma ⁽¹⁷⁾. Phenolic components may be responsible for its antisickling activities ⁽³⁷⁾. In an animal model, MO root extract demonstrated protective effects on the liver and kidney in a dose-dependent manner ⁽²²⁾. It reduced urinary oxalates and may help prevent urolithiasis ⁽²³⁾. MO extract may protect against stomach ulcers by modulating 5-HT₃ receptors ⁽²⁴⁾ and lower cholesterol by inhibiting HMG-CoA reductase ⁽²⁵⁾.

  A water extract of MO showed hormone-modulating properties, stimulated uterine and cervical epithelium metaplasia ^(26) (27), and exhibited antifertility effects ⁽²⁸⁾. A leaf extract of MO exhibited protective effects against Alzheimer’s disease by modulating monoamines in the brain ⁽²⁹⁾. It also may help promote wound healing by increasing collagen deposits ⁽³⁰⁾. Anticancer effects with MO may occur via apoptosis ^(3) (4) and NF-kappaB inhibition ^(5) (46). In an animal model, an MO extract helped prevent chemically-induced tumor formation by increasing glutathione activity ⁽⁶⁾.

• Warnings

  MO was found to be genotoxic at supra-supplementation levels of 3,000 mg/kg body weight in a murine model ⁽³⁹⁾.

• Adverse Reactions

  As studies in humans are limited, the following effects have been found in laboratory studies:

  • Alkaloids in MO have hypotensive and bradycardiac effects ⁽³¹⁾.
  • MO bark can cause uterine contractions ⁽²⁷⁾.
  • Phenylacetonitrile isolated from roasted MO seeds has mutagenic activity ^(32) (33).
  • MO extracts have antifertility properties ⁽²⁸⁾.
  • Animal models suggest that chronic administration of MO leaves can increase risk of hepatic and renal damage ⁽⁴⁰⁾.
• Herb-Drug Interactions
  • Cytochrome P450 substrates, including CYP3A4: MO inhibits CYP-450 / CYP3A4. It can increase the bioavailability of rifampin ⁽³⁴⁾, and may interact with other drugs metabolized by CYP3A4 ⁽³⁵⁾.
  • Sitagliptin: Chronic co-administration with MO decreases the antihyperglycemic effect of sitagliptin ⁽⁴⁷⁾.
• Herb Lab Interactions

  May reduce blood glucose levels ^(7) (12).

• References

  1. Lurling M, Beekman W. Anti-cyanobacterial activity of Moringa oleifera seeds. J Appl Phycol. Aug 2010;22(4):503-510.

  2. Guevara AP, Vargas C, Sakurai H, et al. An antitumor promoter from Moringa oleifera Lam. Mutat Res. Apr 6 1999;440(2):181-188.

  3. Kalkunte S, Swamy N, Dizon DS, Brard L. Benzyl isothiocyanate (BITC) induces apoptosis in ovarian cancer cells in vitro. J Exp Ther Oncol. 2006;5(4):287-300.

  4. Satyan KS, Swamy N, Dizon DS, et al. Phenethyl isothiocyanate (PEITC) inhibits growth of ovarian cancer cells by inducing apoptosis: role of caspase and MAPK activation. Gynecol Oncol. Oct 2006;103(1):261-270.

  5. Lampronti I, Khan MT, Bianchi N, et al. Bangladeshi medicinal plant extracts inhibiting molecular interactions between nuclear factors and target DNA sequences mimicking NF-kappaB binding sites. Med Chem. Jul 2005;1(4):327-333.

  6. Bharali R, Tabassum J, Azad MR. Chemomodulatory effect of Moringa oleifera, Lam, on hepatic carcinogen metabolising enzymes, antioxidant parameters and skin papillomagenesis in mice. Asian Pac J Cancer Prev. Apr-Jun 2003;4(2):131-139.

  7. Sreelatha S, Padma PR. Protective mechanisms of Moringa oleifera against CCl(4)-induced oxidative stress in precision-cut liver slices. Forsch Komplementmed. 2010;17(4):189-194.

  8. Atawodi SE, Atawodi JC, Idakwo GA, et al. Evaluation of the polyphenol content and antioxidant properties of methanol extracts of the leaves, stem, and root barks of Moringa oleifera Lam. J Med Food. Jun 2010;13(3):710-716.

  9. Chumark P, Khunawat P, Sanvarinda Y, et al. The in vitro and ex vivo antioxidant properties, hypolipidaemic and antiatherosclerotic activities of water extract of Moringa oleifera Lam. leaves. J Ethnopharmacol. Mar 28 2008;116(3):439-446.

  10. Chattopadhyay S, Maiti S, Maji G, et al. Protective Role of Moringa oleifera (Sajina) Seed on Arsenic-Induced Hepatocellular Degeneration in Female Albino Rats. Biol Trace Elem Res. 2011 Aug;142(2):200-12.

  11. Fakurazi S, Hairuszah I, Nanthini U. Moringa oleifera Lam prevents acetaminophen induced liver injury through restoration of glutathione level. Food Chem Toxicol. Aug 2008;46(8):2611-2615.

  12. Jaiswal D, Kumar Rai P, Kumar A, Mehta S, Watal G. Effect of Moringa oleifera Lam. leaves aqueous extract therapy on hyperglycemic rats. J Ethnopharmacol. Jun 25 2009;123(3):392-396.

  13. Cheenpracha S, Park EJ, Yoshida WY, et al. Potential anti-inflammatory phenolic glycosides from the medicinal plant Moringa oleifera fruits. Bioorg Med Chem. Sep 1 2010;18(17):6598-6602.

  14. Sashidhara KV, Rosaiah JN, Tyagi E, et al. Rare dipeptide and urea derivatives from roots of Moringa oleifera as potential anti-inflammatory and antinociceptive agents. Eur J Med Chem. Jan 2009;44(1):432-436.

  15. Mahajan SG, Mehta AA. Immunosuppressive activity of ethanolic extract of seeds of Moringa oleifera Lam. in experimental immune inflammation. J Ethnopharmacol. Jul 6 2010;130(1):183-186.

  16. Mahajan SG, Mehta AA. Inhibitory Action of Ethanolic Extract of Seeds of Moringa oleifera Lam. On Systemic and Local Anaphylaxis.J Immunotoxicol. Oct 2007;4(4):287-294.

  17. Mahajan SG, Banerjee A, Chauhan BF, et al. Inhibitory effect of n-butanol fraction of Moringa oleifera Lam. seeds on ovalbumin-induced airway inflammation in a guinea pig model of asthma. Int J Toxicol. Nov-Dec 2009;28(6):519-527.

  18. Rahman MM, Akhter S, Jamal MA, et al. Control of coliform bacteria detected from diarrhea associated patients by extracts of Moringa oleifera. Nepal Med Coll J. Mar 2010;12(1):12-19.

  19. Firth J, Balraj V, Muliyil J, et al. Point-of-use interventions to decrease contamination of drinking water: a randomized, controlled pilot study on efficacy, effectiveness, and acceptability of closed containers, Moringa oleifera, and in-home chlorination in rural South India. Am J Trop Med Hyg. May 2010;82(5):759-765.

  20. Ayanbimpe GM, Ojo TK, Afolabi E, Opara F, Orsaah S, Ojerinde OS. Evaluation of extracts of Jatropha curcas and Moringa oleifera in culture media for selective inhibition of saprophytic fungal contaminants. J Clin Lab Anal. 2009;23(3):161-164.

  21. Lipipun V, Kurokawa M, Suttisri R, et al. Efficacy of Thai medicinal plant extracts against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res. Nov 2003;60(3):175-180.

  22. Mazumder UK, Gupta M, Chakrabarti S, Pal D. Evaluation of hematological and hepatorenal functions of methanolic extract of Moringa oleifera Lam. root treated mice. Indian J Exp Biol. Jun 1999;37(6):612-614.

  23. Karadi RV, Gadge NB, Alagawadi KR, Savadi RV. Effect of Moringa oleifera Lam. root-wood on ethylene glycol induced urolithiasis in rats. J Ethnopharmacol. Apr 21 2006;105(1-2):306-311.

  24. Debnath S, Biswas D, Ray K, Guha D. Moringa oleifera induced potentiation of serotonin release by 5-HT(3) receptors in experimental ulcer model. Phytomedicine. 2011 Jan 15;18(2-3):91-5.

  25. Duangjai A, Ingkaninan K, Limpeanchob N. Potential mechanisms of hypocholesterolaemic effect of Thai spices/dietary extracts. Nat Prod Res. Jul 8 2010:1-12.

  26. Shukla S, Mathur R, Prakash AO. Biochemical and physiological alterations in female reproductive organs of cyclic rats treated with aqueous extract of Moringa oleifera Lam. Acta Eur Fertil. Jul-Aug 1988;19(4):225-232.

  27. Prakash AO, Pathak S, Shukla S, Mathur R. Uterine histoarchitecture during pre and post-implantation periods of rats treated with aqueous extract of Moringa oleifera Lam. Acta Eur Fertil. Mar-Apr 1987;18(2):129-135.

  28. Shukla S, Mathur R, Prakash AO. Antifertility profile of the aqueous extract of Moringa oleifera roots. J Ethnopharmacol. Jan 1988;22(1):51-62.

  29. Ganguly R, Guha D. Alteration of brain monoamines & EEG wave pattern in rat model of Alzheimer’s disease & protection by Moringa oleifera. Indian J Med Res. Dec 2008;128(6):744-751.

  30. Rathi BS, Bodhankar SL, Baheti AM. Evaluation of aqueous leaves extract of Moringa oleifera Linn for wound healing in albino rats. Indian J Exp Biol. Nov 2006;44(11):898-901.

  31. Faizi S, Siddiqui BS, Saleem R, Siddiqui S, Aftab K, Gilani AH. Isolation and structure elucidation of new nitrile and mustard oil glycosides from Moringa oleifera and their effect on blood pressure. J Nat Prod. Sep 1994;57(9):1256-1261.

  32. Villasenor IM, Lim-Sylianco CY, Dayrit F. Mutagens from roasted seeds of Moringa oleifera. Mutat Res. Oct 1989;224(2):209-212.

  33. Villasenor IM, Finch P, Lim-Sylianco CY, Dayrit F. Structure of a mutagen from roasted seeds of Moringa oleifera. Carcinogenesis. Jun 1989;10(6):1085-1087.

  34. Pal A, Bawankule DU, Darokar MP, et al. Influence of Moringa oleifera on pharmacokinetic disposition of rifampicin using HPLC-PDA method: a pre-clinical study. Biomed Chromatogr. 2011 Jun;25(6):641-5.

  35. Monera TG, Wolfe AR, Maponga CC, Benet LZ, Guglielmo J. Moringa oleifera leaf extracts inhibit 6beta-hydroxylation of testosterone by CYP3A4. J Infect Dev Ctries. 2008;2(5):379-383.

  36. Ghiridhari VVA, Malhati D, Geetha K. Anti-diabetic properties of drumstick (Moringa oleifera) leaf tablets. Int J Health Nutr. 2011;2:1-5.

  37. Adejumo OE, Kolapo AL, Folarin AO. Moringa oleifera Lam. (Moringaceae) grown in Nigeria: In vitro antisickling activity on deoxygenated erythrocyte cells. J Pharm Bioallied Sci. Apr 2012;4(2):118-122.

  38. Nambiar VS, Guin P, Parnami S, et al. Impact of antioxidants from drum stick leaves on the lipid profile of hyperlipidemics. J Herb Med Toxicol. 2010;4:165–172.

  39. Asare GA, Gyan B, Bugyei K, et al. Toxicity potentials of the nutraceutical Moringa oleifera at supra-supplementation levels. J Ethnopharmacol. Jan 6 2012;139(1):265-272.

  40. Oyagbemi AA, Omobowale TO, Azeez IO, et al. Toxicological evaluations of methanolic extract of Moringa oleifera leaves in liver and kidney of male Wistar rats. J Basic Clin Physiol Pharmacol. 2013 Mar 18:1-6.

  41. Tang Y, Choi EJ, Han WC, et al. Moringa oleifera from Cambodia Ameliorates Oxidative Stress, Hyperglycemia, and Kidney Dysfunction in Type 2 Diabetic Mice. J Med Food. 2017 May;20(5):502-510.

  42. Dzotam JK, Touani FK, Kuete V. Antibacterial and antibiotic-modifying activities of three food plants (Xanthosoma mafaffa Lam., Moringa oleifera (L.) Schott and Passiflora edulis Sims) against multidrug-resistant (MDR) Gram-negative bacteria. BMC Complement Altern Med. 2016 Jan 11;16:9.

  43. Kim Y, Wu AG, Jaja-Chimedza A, Graf BL, Waterman C, Verzi MP, Raskin I. Isothiocyanate-enriched moringa seed extract alleviates ulcerative colitis symptoms in mice. PLoS One. 2017 Sep 18;12(9):e0184709.

  44. >Anthanont P, Lumlerdkij N, Akarasereenont P, Vannasaeng S, Sriwijitkamol A. Moringa Oleifera Leaf Increases Insulin Secretion after Single Dose Administration: A Preliminary Study in Healthy Subjects. J Med Assoc Thai. 2016 Mar;99(3):308-13.

  45. Tshingani K, Donnen P, Mukumbi H, Duez P, Dramaix-Wilmet M. Impact of Moringa oleifera lam. Leaf powder supplementation versus nutritional counseling on the body mass index and immune response of HIV patients on antiretroviral therapy: a single-blind randomized control trial. BMC Complement Altern Med. 2017 Aug 22;17(1):420.

  46. Berkovich L, Earon G, Ron I, Rimmon A, Vexler A, Lev-Ari S. Moringa Oleifera aqueous leaf extract down-regulates nuclear factor-kappaB and increases cytotoxic effect of chemotherapy in pancreatic cancer cells. BMC Complement Altern Med. 2013 Aug 19;13:212.

  47. Olurishe C, Kwanashie H, Zezi A, Danjuma N, Mohammed B. Chronic administration of ethanol leaf extract of Moringa oleifera Lam. (Moringaceae) may compromise glycaemic efficacy of Sitagliptin with no significant effect in retinopathy in a diabetic rat model. J Ethnopharmacol. 2016 Dec 24;194:895-903.