Benefits
Blood pressure in a single prehypertensive juice trial
In one 3 month randomized study, 143 adults with prehypertension and high-normal uric acid drank about 200 g of soursop fruit juice a day or were left untreated. The juice group ended with lower average systolic blood pressure than the untreated group. There was no placebo and no blinding, the product was ordinary fruit juice rather than a standardized supplement, and no larger trial has repeated the result.
Serum uric acid levels in the same small study
In that same prehypertension study, serum uric acid was lower in the soursop juice group than in the untreated group over 12 weeks, while kidney function measures did not worsen. This was a single unblinded food study in one Indonesian population, so it does not show that soursop is a dependable way to manage uric acid levels.
Antioxidant compounds measured in the laboratory
Laboratory analyses report that soursop fruit and leaf preparations contain vitamin C, phenolic compounds and other molecules that quench free radicals in test-tube assays. These are chemical measurements made in the lab. They have not been shown to produce any antioxidant health outcome when people actually consume soursop.
Laboratory and animal findings not confirmed in people
Most graviola research is cell-culture and rodent work on its acetogenins, which slow the growth of various cultured cells and change markers in animal models. None of this has been reproduced as a benefit in controlled human trials, and the widely marketed health claims for soursop are not supported by studies in people.
A small surgical add-on trial measured only a lab marker
In a study of 28 adults who had already had bowel-tumor surgery, a soursop leaf extract taken for 8 weeks did not change nutritional status, and the only group difference was a laboratory measure of how their blood serum affected cultured cells. The trial did not measure tumor size, recurrence or survival, so it showed no clinical benefit of any kind.
Mechanism of action
Acetogenins block mitochondrial complex I
The fruit, leaves and seeds contain annonaceous acetogenins such as annonacin. In laboratory studies these are potent inhibitors of complex I, the first enzyme of the cell's energy-producing respiratory chain, which lowers the amount of ATP a cell can make. This same action is the reason the compounds are toxic to nerve cells.
Energy failure drives nerve cell death
In cell and animal studies, blocking complex I starves neurons of ATP. Dopamine-producing neurons appear especially vulnerable. When annonacin was infused into rats it crossed into the brain, lowered brain ATP and caused loss of neurons in the same regions that are damaged in atypical parkinsonism.
Additional alkaloids of concern
Annona species also contain benzyltetrahydroisoquinoline alkaloids such as reticuline. Laboratory and review work has flagged these as further potentially neurotoxic constituents, which adds to the concern about regular, long-term use of the fruit, teas and extracts.
Possible blood pressure and blood sugar effects
Animal studies suggest soursop extracts may lower blood pressure and blood glucose. These effects are not established in people, but they are the basis for caution when soursop is combined with medicines that already lower blood pressure or blood sugar, where the effects could add up.
Clinical trials
Case-control study in Guadeloupe comparing tropical fruit and herbal-tea intake across parkinsonism subtypes and controls (Caparros-Lefebvre et al. 1999, Lancet)
87 patients referred for parkinsonism in Guadeloupe (22 Parkinson's disease, 31 progressive supranuclear palsy, 30 atypical parkinsonism, 4 with motor neuron disease) plus frequency-matched controls.
Patients with atypical parkinsonism or progressive supranuclear palsy reported much higher regular consumption of Annonaceae fruit and herbal tea than controls (fruit odds ratio about 20.7, herbal tea about 6.48) and than patients with typical Parkinson's disease. This is observational: it shows a strong association, not proof, and the authors called for larger study.
Analysis of lifelong cumulative Annonaceae consumption against disease severity and cognition in Caribbean parkinsonian patients (Cleret de Langavant et al. 2022, Mov Disord)
180 Caribbean patients with degenerative parkinsonism, including Parkinson's disease, grouped by symptom severity using unsupervised clustering.
Even low cumulative fruit or juice intake (above 0.2 fruit-years), or any Annonaceae herbal tea, was associated with worse disease severity and cognitive deficits (odds ratio about 3.76 for fruit and juice, about 2.91 for herbal tea). The authors called for more restrictive public-health advice. Observational dose-response data, not a treatment trial.
Comparison of motor and cognitive symptoms in Annonaceae-exposed Caribbean versus non-exposed mainland French Parkinson's disease patients (Ribeyron et al. 2026, Behav Neurol)
74 Caribbean and 104 mainland France patients with Parkinson's disease, compared after propensity matching and adjustment for age, disease duration, education and dopaminergic therapy.
Almost all Caribbean patients (71 of 74) had been exposed to Annonaceae fruit, versus none of those interviewed in mainland France. Caribbean patients had more severe motor scores (UPDRS-3 about 24.4 vs 18.5) and worse cognitive scores. The authors urged public awareness of the risks. Observational, so exposure is linked to, not proven to cause, the greater severity.
Randomized but unblinded study of soursop fruit juice versus no treatment in a prehypertensive population (Alatas et al. 2020, J Hum Hypertens)
143 adults with essential prehypertension and high-normal serum uric acid, selected from an Indonesian cohort; treatment group drank 2 x 100 g soursop juice a day for 3 months, control group untreated.
The juice group had significantly lower mean systolic blood pressure, and lower serum uric acid, than the untreated group over 12 weeks, with no worsening of kidney function. There was no placebo and no blinding, and the product was fruit juice rather than a supplement, so the result is weak and unconfirmed.
Randomized double-blind placebo-controlled trial of a soursop leaf extract in patients after colorectal tumor resection (Indrawati et al. 2017, Asia Pac J Clin Nutr)
30 outpatients who had undergone primary colorectal tumor resection; 28 completed, split between soursop leaf extract and placebo for 8 weeks.
The only reported difference was a laboratory (ex vivo) measure in which serum from the extract group was more cytotoxic to cultured cells than serum from the placebo group. Nutritional status was tracked but no clinical outcome such as tumor size, recurrence or survival was measured, and the authors said further research is needed. No health benefit was shown.
Animal study infusing annonacin, the main acetogenin of Annona muricata, into rats for 28 days (Champy et al. 2004, J Neurochem)
Rats given annonacin by osmotic minipump at 3.8 and 7.6 mg per kg per day for 28 days; this is an animal study, not a human trial.
Annonacin entered the brain, lowered brain ATP by about 44%, and caused significant loss of dopamine neurons in the substantia nigra (about -32%) and of neurons in the striatum, with more astrocytes and microglia. The damage pattern resembled that seen in Caribbean atypical parkinsonism, supporting the idea that the acetogenin is neurotoxic.