Cissus Quadrangularis (Hadjod)

Cissus quadrangularis
Evidence Level
Limited
3 Clinical Trials
9 Documented Benefits
2/5 Evidence Score

Cissus quadrangularis (Hadjod or 'bone-setter') is an Ayurvedic succulent vine, often standardized to 2.5% ketosterones. The human evidence is limited. The weight and metabolic trials come from a single research group that has not been independently replicated, and mostly tested a proprietary formulation or a Cissus plus Irvingia combination rather than isolated Cissus (though one small trial did include a Cissus-only arm with positive weight results). The joint-comfort data are one small uncontrolled pilot (29 men, no placebo). A randomized trial in postmenopausal women with osteopenia found no change in bone mineral density versus placebo. Traditional use for bones and fractures is long-standing, but modern human fracture-healing data are limited and low quality.

Studied Dose Joint pilot: 3,200 mg/day (Bloomer 2013). Bone RCT: 1,200-1,600 mg/day (Benjawan 2022). Weight trials: a proprietary Cissus formulation twice daily (Oben 2006, 2008).
Active Compound Cissus quadrangularis aerial-parts extract standardized to 2.5% ketosterones (ketosteroids); plus flavonoids, triterpenoids, saponins.

Benefits

Joint pain fell in a small uncontrolled pilot

In an 8-week uncontrolled pilot, 29 exercise-trained men took Cissus quadrangularis 3,200 mg/day with no placebo group. Self-reported joint pain (WOMAC) fell by about 31% from baseline, but with no control arm this cannot be separated from natural variation or expectation. The authors themselves called for a placebo-controlled trial to confirm it, and no clinical measures (blood pressure, biomarkers) changed.

Weight management: 123-subject formulation trial

In a double-blind randomized trial in 123 overweight and obese adults, a proprietary Cissus quadrangularis formulation (not isolated Cissus) reduced body weight, central obesity, fasting glucose, cholesterol and triglycerides versus placebo over 8 weeks. Because the product was a multi-ingredient formulation and the trial came from a single industry-linked group that has not been independently replicated, the effect cannot be attributed to Cissus alone and should be read as preliminary.

Bone fracture healing acceleration

Cissus quadrangularis has a long traditional use for bones and fractures, reflected in its name 'Hadjod' (bone-setter). Direct human fracture-healing evidence is limited and low quality (older, mostly small or uncontrolled reports), and the supporting bone mechanisms come largely from animal and cell studies, so accelerated fracture healing is not established in modern controlled trials.

Postmenopausal bone density: no change versus placebo

In a randomized placebo-controlled trial, 134 postmenopausal women with osteopenia took Cissus quadrangularis (1.2 or 1.6 g/day) or placebo for 24 weeks. Bone mineral density did not differ from placebo at any site. The only change was a fall in a bone-formation marker (P1NP), which suggests slower bone remodeling but is a laboratory surrogate, not a measured gain in bone density.

Anti-inflammatory pathway support

Cissus quadrangularis inhibits COX-2 and 5-LOX enzymes — the major inflammatory pathway enzymes. Combined inhibition addresses both prostaglandin and leukotriene inflammatory mediators. Mechanism is broader than typical NSAIDs (which primarily target COX pathways). Reduced inflammation drives the joint pain reduction and broader anti-inflammatory effects.

Weight loss synergy with African mango

In a 10-week trial from the same research group (72 participants), a Cissus plus Irvingia gabonensis combination reduced weight and body fat more than placebo, and somewhat more than Cissus alone. Because this is a combination product, the larger effect cannot be attributed to Cissus, and the very large weight changes reported by this single group have not been independently replicated.

Metabolic syndrome multi-marker improvement

The metabolic changes reported for Cissus (weight, glucose, lipids) come from a small number of trials by a single industry-linked group that have not been independently replicated, and mostly tested a proprietary formulation or a Cissus plus Irvingia combination. They should be treated as preliminary rather than as established cardiovascular or metabolic-syndrome benefits.

Appetite suppression and digestive interaction

Researchers believe Cissus helps achieve weight loss by suppressing appetite, reducing food consumption, and interacting with enzymes that digest fats and sugar. Multiple mechanisms supporting weight management vs single-mechanism alternatives. Appetite suppression supports sustained dietary compliance.

Rapid-onset and sedative claims are not established

Claims that Cissus acts within 30 minutes or has sedative and muscle-relaxing effects are not supported by the human trials cited here, which measured joint pain, weight and bone markers over weeks, not acute effects. Treat rapid-onset and sedative claims as unverified.

Mechanism of action

1

COX-2 and 5-LOX inflammatory enzyme inhibition

Cissus quadrangularis inhibits both cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX) inflammatory pathway enzymes. Dual pathway inhibition addresses both prostaglandin (COX) and leukotriene (LOX) inflammatory mediators. More comprehensive anti-inflammatory profile than typical NSAIDs targeting only COX.

2

Ketosterone bone-promoting bioactivity

Ketosterones (also called ketosteroids) are the marker bioactives in standardized Cissus extracts. In preclinical work these steroid-structure compounds have been linked to bone protein synthesis. This is a proposed mechanism: the one human bone-density RCT (Benjawan 2022) found no change in bone mineral density versus placebo, so a bone-preservation effect is not established in people.

3

IGF (Insulin-like Growth Factor) increase

Some preclinical work reports that Cissus quadrangularis can raise IGF (insulin-like growth factor). This is a laboratory and animal finding that has not been shown to translate into measured bone or performance gains in people, so it should not be read as an established anabolic effect.

4

Lipid and glucose metabolism modulation

Cissus supplementation interacts with enzymes that digest fats and sugar — affecting both lipid and glucose metabolism. Mechanism explains the combined effects on weight, glucose tolerance, and lipid profile documented across trials. Multi-pathway metabolic effects support metabolic syndrome applications.

5

Appetite signaling modulation

Cissus has documented appetite-suppressing effects — though specific mechanisms remain incompletely characterized. May involve serotonergic effects or direct satiety signaling. Appetite reduction supports sustainable weight management by reducing caloric intake without willpower dependence.

Clinical trials

1
Cissus Quadrangularis Weight Management: 123-Subject Formulation RCT
PubMed

Double-blind randomized controlled trial evaluating Cissus quadrangularis supplementation in overweight and obese subjects. Foundational efficacy trial. Eligibility: BMI >25, waist circumference >85.5 cm. 8-week intervention with comprehensive metabolic assessment.

123 overweight and obese subjects with BMI 25.5-45.6, waist circumference 85.5-125 cm, weight 62.6-142 kg. 8-week intervention.

A proprietary Cissus quadrangularis formulation (not isolated Cissus) reduced body weight, central obesity, glucose, cholesterol and triglycerides versus placebo over 8 weeks. From a single industry-linked group and not independently replicated, so the result is preliminary and cannot be attributed to Cissus alone. Published in Lipids in Health and Disease.

2
Cissus Exercise-Induced Joint Pain Pilot
PubMed

Pilot study evaluating Cissus quadrangularis effects on exercise-induced joint pain and impairment in trained men. 8-week supplementation period. Published by Bloomer, Farney, McCarthy, Lee in The Physician and Sportsmedicine (small pilot study).

29 exercise-trained men. 8-week intervention.

Self-reported joint pain (WOMAC) fell about 31% from baseline over 8 weeks at 3,200 mg/day. This was an uncontrolled pilot with no placebo group (n=29), so the change cannot be separated from natural variation or expectation, and no clinical biomarkers changed. The authors called for a placebo-controlled trial to confirm it.

3
Cissus Postmenopausal Bone Loss RCT
PubMed

Randomized placebo-controlled trial evaluating Cissus quadrangularis for delaying bone loss in postmenopausal women with osteopenia. Published in Phytomedicine (Benjawan, Nimitphong, et al.).

Postmenopausal women with osteopenia. Randomized placebo-controlled design.

Over 24 weeks in 134 postmenopausal women with osteopenia, bone mineral density did not differ from placebo at any site. A bone-formation marker (P1NP) fell, suggesting slower bone remodeling, but this is a laboratory surrogate and no gain in bone density was measured. The primary bone outcome was null.

Side effects and drug interactions

Common Potential side effects

Generally well-tolerated; 2013 safety review (Stohs and Ray) found Cissus extracts 'exceedingly safe and free of adverse effects at the doses commonly used'.
Mild GI effects in some individuals; taking with food may reduce.
Toxicity studies indicate LD50 >3,000 mg/kg in animals — supports broad safety profile.
Should not be taken pre-workout due to sedative and muscle relaxing properties.
Long-term safety supported by traditional Ayurvedic use as 'Hadjod' (bone-setter).
Possibly safe for use up to 10 weeks per safety data; longer-term data limited.
Pregnancy and lactation: insufficient data; consult clinician.
Filed under several patents in India and US, particularly for anti-osteoporotic properties.

Important Drug interactions

Anticoagulants (warfarin) — Cissus may have mild antiplatelet effects; monitor INR; consult prescriber.
Diabetes medications — additive glucose-lowering effects; monitor blood glucose.
Statins and cholesterol medications — possible additive lipid-lowering effects.
NSAIDs — Cissus has COX-2 and 5-LOX inhibition; theoretical additive effects.
Sedatives and muscle relaxants — Cissus has sedative properties; possible additive effects.
Bisphosphonates and osteoporosis medications — generally complementary; consult prescriber.
Pregnancy and lactation: consult clinician.
Pre-workout supplements — avoid combining; Cissus sedative properties counterproductive.

Frequently asked questions about Cissus Quadrangularis (Hadjod)

What is Cissus quadrangularis used for?

Cissus quadrangularis is a medicinal plant used traditionally for bone and joint health and to support healing of bones and connective tissue. It is also marketed for joint comfort, weight management, and post-workout recovery.

What is Cissus good for?

It is studied and traditionally used for bone health and fracture support, joint comfort, and tendon and ligament recovery, and some products market it for metabolic and weight support. Evidence is mostly preliminary.

How much Cissus quadrangularis should I take?

Doses commonly range from about 300 mg to 3 grams per day depending on the extract; follow product labeling. Standardized extracts are common.

Is Cissus quadrangularis safe?

It is generally reported as well tolerated; mild digestive upset or headache can occur. It may affect blood sugar, so those on diabetes medication should monitor. Check with a doctor if you have a medical condition.

What is Cissus Quadrangularis?

Cissus quadrangularis (Hadjod or 'bone-setter') is an Ayurvedic succulent vine, often standardized to 2.5% ketosterones. The human evidence is limited. The weight and metabolic trials come from a single research group that has not been independently replicated, and mostly tested a proprietary formulation or a Cissus pl…

What is the recommended dosage of Cissus Quadrangularis?

The clinically studied dose is Joint pilot: 3,200 mg/day (Bloomer 2013). Bone RCT: 1,200-1,600 mg/day (Benjawan 2022). Weight trials: a proprietary Cissus formulation twice daily (Oben 2006, 2008). Always follow the product label and check with a healthcare provider for personal advice.

Is Cissus Quadrangularis safe, and does it have side effects?

For most healthy adults, Cissus Quadrangularis is well tolerated at studied doses. Reported effects can include: Generally well-tolerated; 2013 safety review (Stohs and Ray) found Cissus extracts 'exceedingly safe and free of adverse effects at the doses commonly used'. Mild GI effects in some individuals; taking with food may reduce. It may also interact with some medications. Cissus Quadrangularis is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Cissus Quadrangularis interact with any medications?

Possible interactions include: Anticoagulants (warfarin) — Cissus may have mild antiplatelet effects; monitor INR; consult prescriber. Diabetes medications — additive glucose-lowering effects; monitor blood glucose. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Cissus Quadrangularis?

NutraSmarts rates the evidence for Cissus Quadrangularis as Limited (2 out of 5). It is backed by 3 clinical trials and 5 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(5 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Oben J, Kuate D, Agbor G, Momo C, Talla X The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome Lipids Health Dis. 2006;5:24. doi: 10.1186/1476-511X-5-24.PubMedUsed to support: Backs the metabolic/weight claim: a Cissus quadrangularis formulation reduced weight, central obesity and several metabolic markers vs placebo. Honesty: tested a proprietary multi-ingredient formulation (not isolated Cissus), and the trial is small and industry-linked, so evidence is preliminary.
  2. Oben JE, Ngondi JL, Momo CN, Agbor GA, Sobgui CS The use of a Cissus quadrangularis/Irvingia gabonensis combination in the management of weight loss: a double-blind placebo-controlled study Lipids Health Dis. 2008;7:12. doi: 10.1186/1476-511X-7-12.PubMedUsed to support: Backs the weight-management claim: a Cissus + Irvingia combination outperformed placebo on weight and lipid measures. Honesty: a combination product, so effects cannot be attributed to Cissus alone; small, short, and from the same industry-linked group, hence low-quality/preliminary.
  3. Bloomer RJ, Farney TM, McCarthy CG, Lee SR Cissus quadrangularis reduces joint pain in exercise-trained men: a pilot study Phys Sportsmed. 2013;41(3):29-35. doi: 10.3810/psm.2013.09.2021.PubMedUsed to support: In an uncontrolled 8-week pilot, 29 exercise-trained men took Cissus quadrangularis 3,200 mg/day with no placebo group. Self-reported joint pain (WOMAC) fell by about 31% from baseline. With no control arm this signal cannot be separated from natural variation, no clinical biomarkers changed, and the authors called for a placebo-controlled trial to confirm it.
  4. Bafna PS, Patil PH, Maru SK, Mutha RE Cissus quadrangularis L: A comprehensive multidisciplinary review J Ethnopharmacol. 2021;279:114355. doi: 10.1016/j.jep.2021.114355.PubMedUsed to support: Provides authoritative context for the traditional bone/fracture-healing and anti-osteoporotic use (Hadjod) and summarizes phytochemistry and pharmacology. Honesty: a narrative review noting much of the bone evidence is preclinical/traditional, with human fracture-healing data limited and low-quality.
  5. Benjawan S, Nimitphong H, Tragulpiankit P, Musigavong O, Prathanturarug S, Pathomwichaiwat T The effect of Cissus quadrangularis L. on delaying bone loss in postmenopausal women with osteopenia: A randomized placebo-controlled trial Phytomedicine. 2022;101:154115. doi: 10.1016/j.phymed.2022.154115.PubMedUsed to support: In a randomized placebo-controlled trial, 134 postmenopausal women with osteopenia took Cissus quadrangularis at 1.2 or 1.6 g/day or placebo for 24 weeks. Bone mineral density did not differ from placebo at any site (lumbar spine, femoral neck, total hip). The only between-group change was a fall in a bone-formation marker (P1NP), indicating slower bone remodeling, which is a laboratory surrogate rather than a measured gain in bone density. Adverse events did not differ between groups.