DRUGS AND SUPPLEMENTS

Moringa (Moringa spp.)

March 22, 2017

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Moringa (Moringa spp.)

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 1,3-Dibenzyl urea, 3-caffeoylquinic acid, 3-O-(6'-O-oleoyl-beta-D-glucopyranosyl)-beta-sitosterol, 4-(alpha-L-rhamnopyranosyloxy)-benzylglucosinolate, 4(alpha-L-rhamnosyloxy)-benzyl isothiocyanate, 4(alpha-L-rhamnosyloxy)phenylacetonitrile, 4-[(2'-O-acetyl-alpha-l-rhamnosyloxy) benzyl]isothiocyanate, 4-[(4'-O-acetyl-alpha-L-rhamnosyloxy)benzyl]isothiocyanate, 4-(beta-D-glucopyranosyl-1-->4-alpha-L-rhamnopyranosyloxy)-benzyl thiocarboxamide, 4-hydroxyphenyl-acetamide, 4-hydroxyphenylacetontrile, 5,5-dimethyloxazolidine-2-thione, 5-caffeoylquinic acid, al-Ban, alpha-phellandrene, alpha-tocopherol, al-yassar, aromatic glucosinolates, ascorbic acid oxidase, aurantiamide acetate, ben-oil tree, benzaldehyde 4-O-beta-glucoside, benzoic acid 4-O-alpha-rhamnosyl-(1-->2)-beta-glucoside, benzoic acid 4-O-beta-glucoside, benzolive tree, benzyl glucosinolate, benzyl isothiocyanate, benzylamine, beta-carotene, beta-sitosterol, beta-sitosterol-3-O-beta-D-glucopyranoside, Br, Brassicales (order), caffeic acid, caffeoylquinic acid, calcium, chlorogenic acid, cis-11-eicosenoic acid, Cl, cleansing tree, Co, Cr, Cu, cytokinins, des-sulphoglucosinolate, drumstick tree, ellagic acid, ferulic acid, fumaric acid, gallic acid, gamma-tocopherol, gergedi (Nigeria), glucoconringiin, glucosinolates, Go-Lacta®, halleko, hausa tree, heteropolysaccharide, horseradish tree, iron, isobutyl isothiocyanate, kaempferide 3-O-(2'',3''-diacetylglucoside), kaempferide 3-O-(2''-O-galloylrhamnoside), kaempferide 3-O-(2''-O-galloylrutinoside)-7-O-alpha-rhamnoside, kaempferol, kaempferol 3-O-(6''-malonyl-glucoside), kaempferol 3-O-alpha-rhamnoside, kaempferol 3-O-[alpha-rhamnosyl-(1-->2)]-[alpha-rhamnosyl-(1-->4)]-beta-glucoside-7-O-alpha-rhamnoside, kaempferol 3-O-[beta-glucosyl-(1-->2)]-[alpha-rhamnosyl-(1-->6)]-beta-glucoside-7-O-alpha-rhamnoside, kaempferol 3-O-glucoside, kaempferol glycosides, kaempferol rhamnoglucoside, kelor, la mu, lectin, LI85008F, lutein, Madhuca latifolia, malunggay, marango, methyl N-4-(alpha-L-rhamnopyranosyloxy) benzyl carbamate, methyl p-hydroxybenzoate, mkimbo, mlonge (Tanzania), mlongo, Mn, moonga, Moringa aptera, Moringa concanensis, Moringa oleifera, Moringa peregrina, Moringa pterygosperma, Moringa stenopetala, Moringaceae (family), moringine, mother's best friend, mronge, mrongo, mucilages, mulangay, munga, mzungu, mzunze (Kenya), natalac, nebeday, neoxanthin, never die tree, Ni, niazimicin, niaziminin A, niaziminin B, niazirin, niazirinin, O-[2'-hydroxy-3'-(2"-heptenyloxy)]-propyl undecanoate, O-ethyl-4-(alpha-L-rhamnosyloxy)benzyl carbamate, oleic acid, O-(rhamnopyranosyloxy)benzyl glucosinolate, p-cymene, phosphorus, p-hydroxybenzaldehyde, phytic acid, potassium, procyanidin, Prolacta®, pterygospermin, quercetin, quercetin glucosides, quercetin-3-O-(6''-malonyl-glucoside), quercetin 3-O-beta-glucoside, quercetin-3-O-glucoside, quercetin 3-O-rhamnoglucoside (rutin), radish tree, rutin, saijhan (Hindi), sajna, selenium, Shigru (Sanskrit), S-methyl-N-{4-[(alpha-L-rhamnosyloxy)benzyl]}thiocarbamate, spirochin, Sr, surjana, syringic acid, Ti, vaccenic acid, vanillin, violaxanthin, vitamin A, vitamin C, West Indian ben., zeatin, zeatin nucleotide, zeatin riboside, zeaxanthin, zinc, zogale (Nigeria).

  • Note: This review covers several different species of Moringa, including Moringa aptera, Moringa oleifera, Moringa stenopetala, Moringa peregrina, Moringa pterygosperma, and Moringa concanensis.

Background

  • Moringa has been used in a variety of industrial, folkloric, dietary, and medicinal practices. For cooking, moringa has been used as a frying oil and food seasoning and has been eaten as part of curries and salads. Due to its many healthy components, moringa has also been used as a nutritional supplement. Such components include amino acids, antioxidants, fat, minerals, protein, and vitamins. Moringa is thought to contain more vitamin C than oranges, more potassium than bananas, more iron than spinach, and more protein and calcium than milk.

  • The use of moringa in traditional medicine reportedly dates back to ancient times. In spite of the many historical uses of moringa, high-quality research on its proposed health benefits is currently lacking. Limited research in humans suggests that moringa may be used to treat asthma, malnutrition, and lack of vitamin A, and to purify water. In other research, moringa leaf was shown to increase breast milk production in the early period after childbirth. Further research is needed in these areas.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

Breast milk stimulant

Moringa leaf has been used traditionally to promote breast milk production. Products such as Natalac, Go-Lacta®, and Prolacta® have been studied for this use. In human research, moringa leaf was shown to increase breast milk production in the early period after childbirth. More studies are needed to confirm these results.

B

Asthma

Limited research suggests that seed kernels from Moringa oleifera may be used for the treatment of bronchial asthma. Further research is needed in this area.

C

Malnutrition

According to early research, Moringa oleifera leaf powder taken together with ground soybeans and peanuts may increase the weight of underweight children. Further research into the effects of Moringa alone is needed in this area.

C

Vitamin A deficiency

Limited research suggests that Moringa oleifera may improve vitamin A deficiency, and increase the availability of beta-carotene, a vitamin A precursor. When combined with nutritional counseling, Moringa oleifera may be used as a replacement for synthetic vitamin A supplements in children. More high-quality studies are needed in this area.

C

Water purification

Moringa oleifera has shown opposing effects for water purification. Although moringa has been shown to lower bacteria levels initially, this effect appears to disappear over time. As well, moringa lacked any benefits compared to chlorine, an agent commonly used to purify water. Although promising, further research is needed in this area.

C

*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Allergies, antibacterial, anti-fertility agent, antifungal, anti-inflammatory, antimicrobial, antioxidant, antispasmodic (reducing spasms), antiviral, arthritis, ascites (excess fluid in the abdomen), bronchitis, cancer, cardiotonic (improving heart function), childbirth, colds, coma, cosmetic uses, cough, diabetes, diarrhea, digestive aid, dropsy (excess fluid under the skin), emetic (induces vomiting), epilepsy, expectorant (mucus expulsion), eye diseases, fever reduction, fragrance, gastrointestinal conditions, gout, hair tonic, hallucinations, headache, high or low blood pressure, high cholesterol, hysteria (uncontrolled excitement), immune stimulant, improving urine flow, induction of labor/abortion, infections, joint pain, liver protection, low blood sugar, menstrual flow stimulant, nerve pain, pain relief, paralysis, parasites and worms, placental detachment, rheumatism, scurvy (vitamin C deficiency), skin infections, sores, stomach disorders, stomach pain, tetanus, thyroid disease, tonic, tuberculosis, ulcers, vitamin supplementation (vitamins A, C, E, K), wounds.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • Factors such as age and health may affect the amount of Moringa prescribed to different people.

  • For asthma, three grams of dry, powdered Moringa oleifera seed kernel has been taken by mouth twice daily for three weeks.

  • As a breast milk stimulant, the following has been taken by mouth: a moringa capsule (commercial preparation containing 250 milligrams of moringa leaves) every 12 hours on days 3 to 5 after childbirth; 2 moringa capsules (Prolacta®, 350 milligrams per capsule) 3 times daily until ≥ 3 days before delivery.

Children (under 18 years old)

  • Insufficient available evidence.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in people with known allergy or sensitivity to Moringa species.

Side Effects and Warnings

  • Moringa leaves and seeds are likely safe when taken, based on the amounts used in typical dietary or traditional health practices.

  • Moringa may increase the risk of bleeding. Caution is advised in people with bleeding disorders, and in those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Moringa may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Moringa may stimulate the heart and increase blood pressure. Other research suggests that moringa may cause low blood pressure. Caution is advised in people with heart or blood vessel disorders, and in those taking drugs, herbs, or supplements to treat these conditions.

  • Moringa may increase the flow of urine. Caution is advised when using other agents that may also increase urine flow.

  • To purify water, use cautiously during outbreaks of intestinal infections.

  • Avoid consuming moringa root bark and ethanol extracts of moringa leaves and seeds, due to toxic effects. Only minute amounts of moringa root flesh may be consumed due to its spirochin content. Spirochin is a compound that may cause loss of nerve function.

  • Moringa may increase the risk of developing an enlarged thymus gland. Avoid in people with thymus disorders and in those taking drugs, herbs, or supplements to treat these conditions.

  • Moringa may increase the risk of neck swelling due to an enlarged thyroid gland. Avoid use of high doses in areas deficient in iodine.

  • Avoid doses of moringa crude extract in doses greater than 46 milligrams per kilogram of body weight weekly, or seven milligrams per kilogram daily. High doses may have a negative impact on liver and kidney function.

  • Moringa may prevent implantation and induce abortion. Avoid use in women who are pregnant or trying to conceive. However, in human research of pregnant women ≥ 36 weeks gestation, adverse effects associated with use of moringa leaf to promote breast milk production were lacking.

  • Avoid use in children, due to a lack of safety information.

  • Avoid with known allergy or sensitivity to Moringa species.

Pregnancy and Breastfeeding

  • Moringa may prevent implantation and induce abortion. It is not recommended for use in women who are pregnant or trying to conceive. However, in human research of pregnant women ≥ 36 weeks gestation, adverse effects associated with use of moringa leaf to promote breast milk production were lacking. Moringa leaf has been used traditionally to promote breast milk production. Products such as Natalac, Go-Lacta®, and Prolacta® have been studied for this use. In human research, moringa leaf was shown to increase breast milk production in the early period after childbirth. More research is needed in this area.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Moringa may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

  • Moringa may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Moringa may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

  • Moringa may also interact with acetaminophen, agents that affect blood pressure, agents that affect the heart, agents that affect the kidneys, agents that affect the immune system, agents that affect the nervous system, agents that affect the stomach, agents that are toxic to the liver, agents used to increase breast milk, antiarsenic agents, antiasthma drugs, antibiotics, anticancer agents, antifungals, antiparasitics, antivirals, aspirin, carbon tetrachloride, chelating agents (chemical agents that bind metal particles), drugs that reduce eye clouding, fertility agents, inflammation-lowering agents, lipid-lowering agents, mosquito repellants, pain-relievers, penicillin, pentobarbitone, radiation therapy, rifampin, scopolamine, spasm-reducing agents, testosterone, thyroid hormones, tuberculosis treatments, urine-promoting agents, and wound-healing agents.

Interactions with Herbs and Dietary Supplements

  • Moringa may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Gingko biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Moringa may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • Moringa may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

  • Moringa may also interact with agents that affect blood pressure, antiarsenic herbs and supplements, antiasthma herbs and supplements, antibacterials, anticancer agents, antifungals, antioxidants, antiparasitics, antivirals, calcium, chelating agents (chemical agents that bind metal particles), fertility agents, herbs and supplements that affect the heart, herbs and supplements that affect the kidneys, herbs and supplements that affect the immune system, herbs and supplements that affect the nervous system, herbs and supplements that affect the stomach, herbs and supplements that reduce eye clouding, herbs and supplements that are toxic to the liver, herbs and supplements used to increase breast milk, inflammation-lowering herbs, lipid-lowering agents, mosquito repellants, pain-relievers, probiotics (healthy bacteria), spasm-reducing agents, tamarind, urine-promoting agents, vitamins A and E, and wound-healing herbs and supplements.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Agrawal B, Mehta A. Antiasthmatic activity of Moringa oleifera Lam: a clinical study. Indian J Pharmacol 2008;40(1):28-31. View Abstract

  2. Anwar F, Latif S, Ashraf M, et al. Moringa oleifera: a food plant with multiple medicinal uses. Phytother Res 2007;21(1):17-25. View Abstract

  3. 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 2010;13(3):710-716. View Abstract

  4. Beltran-Heredia J, Sanchez-Martin J. Improvement of water treatment pilot plant with Moringa oleifera extract as flocculant agent. Environ Technol 2009;30(6):525-534. View Abstract

  5. Bose CK. Possible role of Moringa oleifera Lam. root in epithelial ovarian cancer. MedGenMed 2007;9(1):26. View Abstract

  6. Devaraj VC, Asad M, Prasad S. Effect of leaves and fruits of Moringla oleifera on gastric and duodenal ulcers. Pharm Biol 2007;45:332-338.

  7. Ejoh RA, Dever JT, Mills JP, et al. Small quantities of carotenoid-rich tropical green leafy vegetables indigenous to Africa maintain vitamin A status in Mongolian gerbils (Meriones unguiculatus). Br J Nutr 2010;103(11):1594-1601. View Abstract

  8. 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 2010;82(5):759-765. View Abstract

  9. Goyal BR, Goyal RK, Mehta AA. Investigation into the mechanism of anti-asthmatic action of Moringa oleifera. J Diet Suppl 2009;6(4):313-327.

  10. Jaiswal D, Kumar Rai P, Kumar A,et al. Effect of Moringa oleifera Lam. leaves aqueous extract therapy on hyperglycemic rats. J Ethnopharmacol 2009;123(3):392-396. View Abstract

  11. Jilcott SB, Ickes SB, Ammerman AS, et al. Iterative design, implementation and evaluation of a supplemental feeding program for underweight children ages 6-59 months in Western Uganda. Matern Child Health J 2010;14(2):299-306. View Abstract

  12. Muyibi SA, Alfugara AMS. Treatment of surface water with Moringa Oleifera seed extract and alum - a comparative study using a pilot scale water treatment plant. Int J Environ Stud 2003;60(6):617-626.

  13. Nandave, M., Ojha, S. K., Joshi, S., Kumari, S., and Arya, D. S. Moringa oleifera leaf extract prevents isoproterenol-induced myocardial damage in rats: evidence for an antioxidant, antiperoxidative, and cardioprotective intervention. J Med Food 2009;12(1):47-55. View Abstract

  14. Sulaiman MR, Zakaria ZA, Bujarimin AS, et al. Evaluation of Moringa oleifera aqueous extract for antinociceptive and anti-inflammatory activities in animal models. Pharm Biol 2008;46:838-845.

  15. Thurber MD, Fahey JW. Adoption of Moringa oleifera to combat under-nutrition viewed through the lens of the "diffusion of innovations" theory. Ecol Food Nutr 2009;48(3):212-225. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Updated:  

March 22, 2017