Guanabana (Annona muricata) is a fruit tree and member of the custard apple family (Annonaceae). The guanabana leaf has been studied extensively for its anti-cancer properties, but traditional medicine has used all parts of the tree for pain, inflammation, malaria, diabetes, and parasites. Read on to learn about the benefits and side effects of guanabana.
What is Guanabana?
Guanabana, also known as soursop or graviola, is native to tropical areas of Central and South America and the Caribbean. It is part of the custard apple family and is now widely cultivated in tropical and subtropical areas worldwide, including Africa and Southeast Asia [1, 2].
The guanabana is most known for its creamy, tangy fruit pulp. But, traditional practices have used all portions of the guanabana plant to treat conditions from fever to malaria .
More than 200 phytochemicals in guanabana have been studied for their ability to prevent cancer and other chronic diseases .
The guanabana seed and leaf contain large amounts of vitamins C and E, responsible in part for its potent antioxidant effects .
More than 200 chemical compounds have been identified and isolated from the guanabana plant, the most notable being alkaloids, phenols, and acetogenins .
The primary active phytochemicals in the leaf, seed, stem, and pulp of the guanabana are acetogenins. These chemicals act against cancerous tumors parasites, inflammation, microbes, and insects [6, 7, 8, 9, 10].
Mechanism of Action
Guanabana leaf extracts protected against diabetes in rats by reducing blood sugar levels and increasing insulin. This was explained by increased antioxidant levels in the liver, reduced fat oxidation, and protection of pancreatic β-cells [13, 14, 15].
Cell models suggest that the extracts of guanabana leaves exert their antioxidant activity by scavenging free radicals. Reducing free radicals helps prevent damage to cells, proteins, and DNA [16, 17].
Extracts from guanabana leaves can reduce the number of cancer tumor cells by:
- Blocking energy (ATP) production in cancer cells 
- Selectively increasing programmed cell death (apoptosis) in cancer cells [19, 20]
Guanabana extracts increase apoptosis in cancer cells by:
- Activating a mitochondrial-mediated pathway with NF-kB and Bcl-Xl [20, 21]
- Changing the cancer cell’s structure 
- Disrupting the cancer cell’s membrane mitochondrial potential [22, 23]
- Preventing cell division of cancer’s cell cycle [22, 23]
- Creating reactive oxygen species [22, 24]
Health Benefits of Guanabana
1) Guanabana Has Anti-Cancer Effects
Acetogenins in the guanabana are the most promising molecules to protect against and kill cancer cells. These phytochemicals are produced in the guanabana fruit, leaves, stems, bark, and seeds [25, 9].
The compounding effects of multiple phytochemicals in guanabana extracts, including acetogenins, may be the underlying reason for their potency in cancer treatment .
Guanabana Combats Colon Cancer
Guanabana leaf extracts reduced cancerous tissue in the colon of rats by inducing apoptosis in cancer cells .
Mice injected with acetogenins from guanabana leaves had 50% fewer pre-cancerous colon cells .
Acetogenins extracted from guanabana seeds were selectively toxic to colon cancer cells and were 10,000 times more potent than chemotherapy medication .
Guanabana Combats Breast Cancer
Almost daily use of guanabana tea for 5 years stabilized breast cancer in a 66-year-old woman following chemotherapy treatment .
The acetogenin and annonacin increased apoptosis (cell death) in breast cancer cells and reduced breast tumors in mice through estrogen-related pathways .
Guanabana fruit extract reduced breast tumor growth in rats by 32% after 5 weeks .
Acetogenins extracted from guanabana leaf decreased breast cancer cell growth by 98% .
Guanabana Combats Prostate Cancer
In rats, guanabana leaf extract reduced prostate size, possibly through apoptosis .
Guanabana leaf extracts reduced prostate tumor growth in mice but fractions containing only acetogenins killed mice due to toxicity .
Guanabana Combats Lung Cancer
Guanabana Combats Skin Cancer
Guanabana Combats Liver Cancer
Guanabana Combats Pancreatic Cancer
Guanabana Combats Cervical Cancer
Guanabana leaf extracts reduced the growth of cervical cancer cells by 80% .
Annonacin, an acetogenin extracted from the seeds of guanabana, increased apoptosis in endometrial cancer cells by 65%. The mechanism was linked to DNA damage of the cancer cells .
Guanabana Combats Leukemia
Leaves, twigs, roots, and seeds of the guanabana induced apoptosis in leukemia cancer cells by decreasing the ability of cancerous cells to survive and function, disrupting the membrane of the mitochondria .
2) Guanabana Has Antioxidant Effects
Antioxidants derived from plants can have protective effects against free radicals involved in the development of diseases such as cancer.
According to several studies, the high antioxidant concentrations of guanabana leaves, fruit, and peel prevented oxidative damage in cells by scavenging free radicals and reducing reactive oxygen species. Reactive oxygen species production can result in DNA damage and cell death [16, 58, 59, 60, 61, 27].
Guanabana flower extracts also exhibited high antioxidant activities and could have used as a food oil preservative to prevent spoiling .
3) Guanabana Combats Pathogens
Guanabana peel, leaf, and seed extracts show antimicrobial activity against various microorganisms including parasites, viruses, gram-positive, and gram-negative bacterial strains.
Guanabana Combats Parasites
In the lab, the guanabana peel was more effective in the treatment of leishmaniasis disease than the chemical commonly used for its treatment .
Extracts of guanabana leaf exhibited anti-parasitic activity against the eggs, larvae, and adults of Haemonchus contortus, a gut parasite in sheep .
Guanabana Combats Bacteria
According to several lab studies, extracts from guanabana seeds, roots, leaves, and/or bark had antibacterial activity against Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus albus, Vibrio cholerae, Escherichia coli, Klebsiella pneumonia, Bacillus subtilis, Proteus vulgaris, Enterococcus faecalis, Enterobacter aerogenes, and Providencia stuartii bacteria [71, 10, 72, 73, 74, 75, 76].
Guanabana leaf extracts showed antimicrobial properties by inhibiting the growth of oral pathogens (Streptococcus mutans, Streptococcus mitis, Porphyromonas gingivalis) with 20 to 85% effectiveness when compared to prescription antibiotics .
Guanabana Combats Viruses
Guanabana stem extracts suppressed herpes simplex virus 1 in the kidney cells of monkeys .
Guanabana extracts reduced the replication of herpes simplex virus 2 in human throat cells .
Guanabana Combats Fungus
Guanabana leaf extracts inhibited the growth of Candida albicans .
4) Guanabana May Help Prevent Mosquito-Transmitted Diseases
Isolated acetogenins from guanabana were toxic to mosquito larvae by inhibiting mitochondrial electron transport, which halts energy production in the cells of the larvae .
5) Guanabana Reduces Inflammation
The pulp and skin of the guanabana reduced inflammation in mice by reducing chemical mediators of inflammation (COX and nitric oxide) .
6) Guanabana May Benefit Diabetes
Treatment of diabetic rats with guanabana leaf extracts decreased blood glucose and/or increased insulin. These antidiabetic effects occurred by guanabana extracts increasing antioxidant levels in the liver, reducing fat oxidation and protecting pancreatic β-cells [13, 14, 15, 90].
Guanabana leaf extracts regenerated pancreatic β-cells in diabetic mice .
7) Guanabana May Be Toxic to Insects
Acetogenins from guanabana were toxic to agricultural pests including the potato beetle, green peach aphid, and African cotton leafworm .
8) Guanabana May Improve Liver Health
9) Guanabana May Alleviate Stress, Anxiety, and Depression
Guanabana fruit and leaf extracts reduced stress and showed anti-depressive effects in rats. Phytochemicals in the guanabana fruit and stem influenced the brain by binding to serotonin receptors [103, 104].
Guanabana leaf extracts had sedative and antidepressant-like effects in rats by decreasing anxiety-related behavior such as environment exploration and increased mobility, respectively .
10) Guanabana May Help Heal Wounds
Extracts of the stem and bark of guanabana increased wound healing in rats over 12 days .
11) Guanabana Fruit May Reduce Blood Pressure
Leaf extracts from guanabana reduced blood pressure in rats by blocking calcium channels .
Guanabana fruit extracts reduced a key enzyme (angiotensin-I converting enzyme) involved in increasing blood pressure .
12) Guanabana Leaf May Prevent Stomach Ulcers
Ulcer lesions were reduced in rats pre-treated with guanabana leaf extracts. This action was likely due to the extract’s high antioxidant content, which reduced oxidative damage and protected the stomach wall [109, 110].
13) Guanabana Leaves May Improve Immune Function
Guanabana leaf extracts enhanced the immune activity in macrophage cells by activating the mitogen-activated protein kinase pathway .
14) Guanabana Fruit May Reduce Pain
Guanabana fruit extract reduced chemical and thermal pain in mice, likely by interacting with the opioid pathway .
15) Guanabana Leaf May Decrease Arsenic Toxicity
16) Guanabana Fruit May Boost Male Fertility
Doses of 80, 400, and 2,000 mg/kg of guanabana juice per day for 60 days in rats increased sperm count and movement .
17) Guanabana May Protect the Heart
Guanabana extracts improved heart muscle contractions in guinea pigs following oxygen deprivation .
18) Guanabana May Help Reduce Symptoms of Allergies
Guanabana leaf extracts reduced symptoms of skin allergies in rabbits .
Despite their remarkable anti-cancer potential, guanabana’s acetogenins can be toxic to nerve cells and cross the blood-brain barrier .
Studies on populations in the West Indies suggest a potential relationship between high consumption rates of guanabana fruit and tea, and a higher incidence of movement disorders like atypical parkinsonism [117, 118, 119].
Dietary supplements, including guanabana and other Annonaceae plant species, increased cell death in human brain cells .
Guanabana juice and leaf extracts may intensify the effects of the venomous pit viper snake .
Limitations and Caveats
Most of the benefits of guanabana were only studied in animals and cells. While the findings are significant, these benefits may or may not apply to humans, and these extracts need to be further evaluated for effects, optimal dosage, long-term safety, and potential side effects.
No drug interactions have been documented.
Natural Sources/Forms of Supplementation
Guanabana fruit is typically eaten raw and ripened and can be incorporated into drinks, smoothies, and desserts. The fruit may also be jarred as a puree or as a juice. Seeds should be avoided due to their toxic nature. Guanabana can also be roasted or fried like a vegetable.
Guanabana supplements are available through suppliers but have not been evaluated for potency, effectiveness, or toxicity in humans.
Recommended dosing of guanabana fruit, leaves, stems, or bark has not been established due to the lack of human trials.
Doses of up to 2 g/kg of guanabana juice per day for 60 days were not toxic to rats based on vital organ weight and blood parameters .
Several users found that guanabana supplements helped boost their immune system.
Another reviewer found the supplement improved skin boils, digestive health, and energy.
A woman going through menopause found guanabana supplements to be highly effective in regulating mood, stress, hormones, and blood pressure.