Herbs & Botanicals · Bone-setting vine and weight-loss supplement
Cissus
Cissus quadrangularis · also called Veldt grape, hadjod, bone setter
Cissus is a succulent vine whose stem is used in Ayurveda to help set broken bones and ease sore joints, and is now sold as a weight-loss supplement. Small trials suggest possible weight and joint pain benefits, but many involve blends or one research group, and the one placebo-controlled bone density trial was negative. The main caution is that it may lower blood sugar and add to diabetes medicines.
General information, not medical advice. Last substantive update · Not medically reviewed. A named clinician has not signed off on this page. How this page is made
About Cissus
Cissus quadrangularis is the 'bone setter' vine. Its stem is used in Ayurveda for fractures and joints and in modern supplements for weight loss. Human research is small, often uses blends, and several weight trials come from one group.
What it is
Cissus quadrangularis, also called veldt grape or hadjod, is a succulent vine in the grape family. Its four-angled stem is the part used. The accepted name was confirmed in the GBIF database.
Supplements may come as stem powder, capsules or standardised extracts, sometimes under brand names such as CQR-300 (named in our earlier summary; not verified).
What it is used for
In Ayurveda and folk medicine the stem is used for broken bones and sore joints, hence the names hadjod and bone setter. Today it is also sold for weight loss. We found no EMA, NCCIH or LiverTox page we could read for Cissus.
What the research shows
Bones: a 2025 meta-analysis of 7 randomised studies (354 people) found raised parathyroid hormone but no change in calcium, phosphorus or alkaline phosphatase, with very low certainty. A 24-week placebo-controlled trial in 134 postmenopausal women found no bone density gain. Wrist and jaw fracture trials used blends and were open-label.
Joints: one 8-week pilot in 29 exercise-trained men reported about 31 percent lower pain scores but had no placebo group.
Weight and metabolism: a 2017 meta-analysis found weight loss of 5.19 kg with Cissus blends. A 2025 trial in 248 adults reported 5.8 percent weight loss and higher GLP-1 with an extract, but the abstract mentions no side effects, the effects look unusually large, and many Cissus weight trials come from the same Cameroon research group. Funding and any link to the branded extract were not stated in the abstracts we read.
Hemorrhoids: a 570-person trial found no benefit over placebo.
Steroids, sterols and stilbenes
Cissus is often promoted for 'ketosterones'. A rat study found ketosteroid levels did not predict the bone effect and found no report of male-hormone-like steroids in the plant. A friedelin-rich fraction acted estrogen-like in rats. Phytosterol and resveratrol-type stilbene content was not verified in a source we read.
At a glance
Traditional uses history, not proof
- Broken bones and bone healing (Ayurvedic and folk use; the name hadjod means bone joiner)
- Sore joints
- Hemorrhoids (folk use)
Studied for research
- Fracture healing: hints in small open-label blend trials, low certainty
- Bone density after menopause: no difference from placebo
- Joint pain in exercise-trained men: lower pain scores in an uncontrolled pilot
- Weight and body fat: lower in several short trials, mostly one research group
- Cholesterol and blood sugar: small falls with blends
- Hemorrhoids: no benefit over placebo
Main compounds
- Plant steroids ('ketosterones'), whose link to benefits is doubtful
- Phytosterols such as beta-sitosterol (not verified here)
- Friedelin, a triterpene that acted estrogen-like in rats
- Resveratrol-type stilbenes (not verified here)
Common forms
- Dried stem powder
- Capsules or tablets
- Standardised extracts (including branded ones)
- Blends with Boswellia, Irvingia and other herbs
Research links: PubMed: Cissus quadrangularis in clinical use, meta-analysis (2017) · PubMed: Cissus and bone biomarkers, meta-analysis (2025) · PubMed: Cissus and bone loss after menopause, randomised trial (2022) · PubMed: Cissus and GLP-1 in overweight adults, randomised trial (2025) · PubMed: Cissus and joint pain in exercise-trained men, pilot (2013) · PubMed: Cissus-induced low platelets, case report (2020) · Research Library · Genes & Biomarkers Library
The plant and its history
- Accepted scientific name
- Cissus quadrangularis L.
- Naming authority
- GBIF backbone: accepted species, exact match, confidence 99, checked 2026-10-25.
- Common names
- Cissus (English); Veldt grape (English); Hadjod (Hindi); Bone setter (English)
- Botanical family
- Vitaceae (grape family).
- Classification
- Plantae > Vitales > Vitaceae > Cissus > Cissus quadrangularis
- Native range
- Not verified in a source read.
- Habitat
- Not verified.
- What the plant looks like
- Roots: Not verified.; Stems: The four-sided, segmented succulent stem is the part used (the name 'quadrangularis' means four-angled); not verified in a source read.; Leaves: Not verified.; Flowers: Not verified.; Fruit: Not verified.
- Cultivation
- Not verified.
- Harvest and processing
- Dried stem powder and standardised extracts appear in trials; processing is not described in the abstracts read.
- Look-alikes and adulterants
- Name: Other Cissus species (for example Cissus gongylodes); Note: A different species; one 2026 mouse paper used it. Not interchangeable with C. quadrangularis. Not verified here.
- Sustainability and conservation
- Not verified.
Traditional use and history history, not clinical proof
| Tradition or era | Documented use | Source |
|---|---|---|
| Ayurveda and Indian folk medicine | Stem for fractures and bone and joint complaints; hence the names hadjod and bone setter. | s-rxlist-cissus |
| Modern supplements | Marketed for bones and joints and as a weight-loss ingredient, sometimes under the extract name CQR-300 (named in our earlier summary; not verified here). | s-rxlist-cissus |
Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.
What is inside, and how it may work
What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.
Main compounds
| Compound | Family | Where it is concentrated | Activity studied | Level of evidence |
|---|---|---|---|---|
| Ketosteroids (3-ketosteroids, 'ketosterones') | plant steroid | Stem (per product marketing) | Used to standardise extracts; a 2016 rat study found ketosteroid content did not predict the bone effect and found no report of androgenic steroids in the plant. 5 | Animal research |
| Beta-sitosterol PubChem 222284 | phytosterol | Stem | Common plant sterol; its content in Cissus was NOT verified in a source read here. 18 | Not verified |
| Friedelin PubChem 91472 | triterpene | Stem | A friedelin-rich fraction acted estrogen-like in rats. 1 18 | Animal research |
| Resveratrol PubChem 445154 | stilbene | Stem | Stilbenes are named in descriptions of Cissus, but this was NOT verified in a source read here. 18 | Not verified |
| Piceatannol PubChem 667639 | stilbene | Stem | A resveratrol relative; presence in Cissus NOT verified here. 18 | Not verified |
| Quercetin PubChem 5280343 | flavonol | Stem | Common flavonol; a separate paper on quercetin-rich Cissus fractions exists but was not read. 18 | Not verified |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Incretin pathway (GLP-1 and DPP-4) | GLP-1; DPP-4 enzyme | Higher GLP-1 and lower DPP-4 activity versus placebo in 248 adults taking a Cissus extract. 16 | Human data |
| Fat-cell browning | UCP1 | Cissus extract raised UCP1 mRNA in human white fat cells in the lab, and glycerol release fell. 4 | Laboratory research |
| Bone remodeling | Parathyroid hormone; P1NP and CTX markers | Parathyroid hormone rose in pooled trials; P1NP fell versus placebo with CTX stable in the osteopenia trial. 9 2 | Human data |
| Estrogen receptor-type activity | Not specified in the abstract read | A friedelin-rich fraction acted estrogen-like in ovariectomised rats. 1 | Animal research |
| Liver sugar production | Gluconeogenesis | Lower blood glucose in diabetic mice; details summary-only. 6 | Animal research |
Absorption, metabolism and elimination
- Absorption
- No human data found.
- Distribution
- No human data.
- Metabolism
- Not established in people.
- Elimination
- Not established.
- Bioavailability
- Unknown.
Isolated compounds versus whole extracts
Most lab findings (friedelin fraction, ketosteroid extracts) are for fractions or specific extracts, not for the capsules people buy. The same applies to trial extracts: the 2025 trial used a standardised extract, others used blends. A 2016 rat study found that ketosteroid content, the usual standardisation target, did not track the bone effect.
Nutritional composition
No source read describes Cissus as a food or nutrient source.
4 low certainty2 very low certainty4 not enough evidence1 evidence against
What was looked at
The 11 benefits and uses checked for Cissus, each with how strong the evidence is. Tap one to open it.
- Fracture healingLow certainty
- Bone blood markers (parathyroid hormone)Very low certainty
- Bone density after menopauseLow certainty
- Joint pain in exercise-trained menVery low certainty
- Osteoarthritis and joint damageNot enough evidence
- Traditional "bone setter" useNot enough evidence
- Weight and body fatLow certainty
- Cholesterol, blood sugar and metabolic syndromeLow certainty
- Blood sugar (animal study)Not enough evidence
- HemorrhoidsEvidence against
- Hormone-like effects (lab and animal only)Not enough evidence
Lab markers tracked in the studies
Parathyroid hormone (PTH)Bone mineral density (BMD)P1NP (bone-formation marker)CTX (bone-breakdown marker)Calcium, phosphorus and alkaline phosphataseWOMAC joint scoreRadius Union Scoring System (RUSS)Body weightBody fatWaist and hip circumferenceGLP-1 and DPP-4 activityLDL cholesterol, triglycerides, total cholesterolFasting blood glucose
What is Cissus good for?
The main proposed uses and how strong the human evidence is for each. 'Insufficient' means there are no human studies or the results were not clear. Ratings are this profile's own reading, not formal grades.
Benefits, one by one
Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.
Fracture healing
Low certaintyCissus is known as the "bone setter", but good evidence that it speeds up healing is thin. Reviewers found a possible benefit for fractures and bone pain, rated low certainty, and the fracture trials we found used blends with other herbs and were not blinded.
3 studiesAmounts are not given on this page. The trials used blends (Cissus wi…
Studies, doses and limits
What the trials found
2017 meta-analysis (9 studies, 1108 people, several conditions): Cissus had benefit for bone fractures and had significant effects on bone pain, with GRADE certainty rated low for fractures. 2026 open-label trial of CL16019, a Cissus plus Boswellia product, in 50 people with wrist fractures for 60 days: X-ray healing score 7.96 versus 5.54 with standard care alone (p < 0.0001), and lower pain and better wrist function scores. 2023 open-label trial of a Cissus plus Dalbergia sissoo tablet in 24 people with jaw fractures: some earlier pain relief but not significant, and X-ray healing did not differ between the three groups.
Results
Hints of faster healing and less pain in small, unblinded trials of blends; no placebo-controlled trial of Cissus alone for fractures was found.
Effect sizes as reported
Wrist fracture healing score 7.96 versus 5.54 (p < 0.0001, CL16019 blend, open-label); jaw fracture X-ray healing: no significant difference.
Why this rating
The meta-analysis authors rate fracture evidence low; the individual trials are small, open-label, and test combinations, so Cissus cannot be credited on its own. The "high" and "low" ratings in that review differ by outcome and are theirs.
Form and dose studied
Amounts are not given on this page. The trials used blends (Cissus with Boswellia, or with Dalbergia sissoo).
Who was studied
Adults with wrist or jaw fractures.
Limits
Only abstracts were read. Open-label designs invite bias. The wrist trial tested a named commercial product. No trial of plain Cissus for fractures was found.
Why researchers looked
Cissus has a long reputation in Indian (Ayurvedic) practice as a plant for setting and mending broken bones, which is why the stem is often called hadjod, "bone joiner".
Traditional use
Traditional Ayurvedic and folk use of the stem for broken bones (not verified in a source read here).
Proposed mechanism Animal research
Lab work in animals and cells suggests bone-building cells may be stimulated by some extracts; this is not proof of an effect in people.
A proposed mechanism does not show that the effect happens in people.
Not a replacement for setting and casting a fracture. See the Safety tab, including blood sugar and pregnancy cautions.
Bone blood markers (parathyroid hormone)
Very low certaintyA 2025 pooled analysis found Cissus raised parathyroid hormone, a hormone that controls calcium, but not calcium, phosphorus or alkaline phosphatase. Certainty was very low.
1 studiesNot given in the abstract. Amounts are not given on this page.
Studies, doses and limits
What the trials found
2025 meta-analysis (7 randomised studies, 354 people): parathyroid hormone SMD 1.23 (95% CI 0.79 to 1.67; p < 0.0001); no significant change in calcium, phosphorus or alkaline phosphatase. Risk of bias: most studies had some concerns and two had high risk.
Results
Parathyroid hormone went up; the other bone markers did not change.
Effect sizes as reported
Parathyroid hormone SMD 1.23 (95% CI 0.79 to 1.67)
Why this rating
The authors rate certainty very low for all four markers (GRADE), with few studies and risk-of-bias concerns.
Form and dose studied
Not given in the abstract. Amounts are not given on this page.
Who was studied
Mixed groups across seven studies.
Limits
Abstract only. The pooled studies differ in people, products and length. A higher hormone level is a lab number, not a bone benefit.
Why researchers looked
Blood markers are a quick way to see whether a supplement touches bone chemistry.
Proposed mechanism Preliminary mechanism
Unclear. Parathyroid hormone can both build and break down bone depending on how it is released, so a rise does not show a benefit.
A proposed mechanism does not show that the effect happens in people.
A change in a calcium-controlling hormone is a reason to talk to a doctor if you have a parathyroid, kidney or bone condition.
Bone density after menopause
Low certaintyIn the one placebo-controlled trial in women with early bone thinning (osteopenia), bone density after 24 weeks was no different from placebo, although a bone-building marker was lower.
1 studiesCissus capsules at two levels; Amounts are not given on this page.
Studies, doses and limits
What the trials found
2022 randomised placebo-controlled trial, Phytomedicine: 134 postmenopausal women with osteopenia were enrolled and 108 finished 24 weeks of Cissus at two different levels or placebo. Percent change in bone mineral density did not differ from placebo at any site. The bone-formation marker P1NP fell more than with placebo (for example -9.95 +/- 22.22 percent at week 24 in the higher group, p < 0.01) while CTX stayed stable; the authors read this as slower bone remodeling. Side effects did not differ between groups.
Results
No bone density benefit shown; bone turnover markers moved.
Effect sizes as reported
BMD: no difference from placebo; P1NP lower than placebo at 24 weeks (p < 0.01)
Why this rating
One placebo-controlled trial with a negative main result; 26 of 134 women did not finish; funding not stated in the abstract.
Form and dose studied
Cissus capsules at two levels; Amounts are not given on this page.
Who was studied
Postmenopausal women aged over 40 with osteopenia.
Limits
Single trial, 24 weeks, bone density is a slow measure and no fractures were counted. The authors call the marker change promising but bone density did not change.
Why researchers looked
Women lose bone quickly after menopause, so a plant used for bones has been tested here.
Proposed mechanism Preliminary mechanism
Not established. The trial authors suggest slower bone remodeling.
A proposed mechanism does not show that the effect happens in people.
The trial reported no more side effects than placebo; see the Safety tab for other cautions.
Joint pain in exercise-trained men
Very low certaintyIn a small trial with no placebo group, exercise-trained men with joint pain reported lower pain scores after 8 weeks. Without a comparison group this cannot show that Cissus caused the change.
1 studiesCissus at a fixed daily amount for 8 weeks; Amounts are not given on …
Studies, doses and limits
What the trials found
2013 pilot study, Physician and Sportsmedicine: 29 men aged 20 to 46 with joint pain from strenuous exercise took Cissus for 8 weeks. Mean total WOMAC score fell from 25.4 +/- 2.4 to 17.4 +/- 2.1 (about 31 percent; lower is better). No clinical measure such as heart rate, blood pressure or blood tests changed significantly.
Results
Lower self-rated joint pain, in a study with no control group.
Effect sizes as reported
WOMAC total score 25.4 to 17.4 (about 31 percent lower)
Why this rating
Uncontrolled pilot of 29 men; the authors themselves call for a placebo-controlled study.
Form and dose studied
Cissus at a fixed daily amount for 8 weeks; Amounts are not given on this page.
Who was studied
Healthy, exercise-trained men aged 20 to 46.
Limits
Abstract only. No placebo, so placebo response and natural recovery are possible. Men only; results may not apply to women or older adults. Funding and product source not stated in the abstract.
Why researchers looked
Hard training can lead to joint pain, and Cissus has been marketed to athletes for that reason.
Traditional use
Traditional use for joints and bones.
Proposed mechanism Animal research
Anti-inflammatory activity has been reported in lab studies; no mechanism was shown in this trial.
A proposed mechanism does not show that the effect happens in people.
No clinical measures changed in this study; see the Safety tab.
Osteoarthritis and joint damage
Not enough evidenceWe found no randomised trial of Cissus for knee or hip osteoarthritis in people. The joint findings we found were in rats and cells, which cannot show a benefit in people.
1 studiesNot applicable.
Studies, doses and limits
What the trials found
No controlled human osteoarthritis trial was found in our PubMed search. The single human joint study we found is the uncontrolled athlete pilot above.
Results
No human evidence.
Effect sizes as reported
Not available.
Why this rating
No controlled trials in people with osteoarthritis were found.
Limits
Lab and animal results are not a basis for expecting benefit in people. We did not read the animal studies in detail.
Why researchers looked
Cissus is promoted for joint wear and cartilage, so it is natural to ask whether anyone has tested that.
Traditional use
Traditional Ayurvedic use for joints.
Proposed mechanism Animal research
Rat and cell studies describe lower inflammation and some cartilage protection with certain extracts; these are lab and animal findings only.
A proposed mechanism does not show that the effect happens in people.
Joint pain that persists should be checked by a doctor.
Traditional "bone setter" use
Not enough evidenceIn Ayurvedic and folk practice the stem has long been taken for fractures and sore joints, which is where the names hadjod and bone setter come from. This tradition is not the same as trial proof.
0 studiesNot applicable.
Studies, doses and limits
What the trials found
No source read here documents how the stem was traditionally prepared. A few of the trials above give some context but none is a historical source.
Results
Traditional use only.
Effect sizes as reported
Not available.
Why this rating
Traditional use is not evidence of effect.
Limits
We did not read ethnobotanical sources, so the traditional claims are carried over from our earlier summary and are marked as not verified.
Why researchers looked
It explains why researchers chose fractures and bone biomarkers as the first things to test.
Traditional use
Stem used in India and parts of Africa and Asia for fractures, sore joints and as a general tonic (from our earlier summary; not independently checked).
Proposed mechanism Traditional use
Not applicable.
A proposed mechanism does not show that the effect happens in people.
See the Safety tab.
Weight and body fat
Low certaintySeveral trials, mostly from one research group in Cameroon, report weight and fat loss with Cissus extracts or blends. Pooled results look good for blends but come from a few small trials, and the newest one needs independent repeating.
5 studiesCissus-only extract in the 2025 and 2008 trials; blends in the meta-a…
Studies, doses and limits
What the trials found
2017 meta-analysis (9 studies): combination products lowered body weight by 5.19 kg (95% CI -8.82 to -1.55) versus placebo, GRADE rated high by the reviewers; Cissus-only pooling was not possible. 2025 randomised trial (Medicina, 248 adults with BMI 25 to 34.9, 16 weeks): Cissus extract versus placebo and semaglutide arms: weight -5.8 percent, body fat -10.9 percent, GLP-1 +42.2 pg/mL, DPP-4 activity -17.8 percent (all p < 0.01); the abstract calls this comparable to semaglutide and reports no side effects. 2008 trial (72 adults, 10 weeks): Cissus alone and Cissus with Irvingia gabonensis both beat placebo on weight, body fat and waist, with the combination doing more. 2006 trial (123 adults, 8 weeks): significant net weight and waist reductions with a Cissus formulation, with or without diet. 2021 Thai trial: waist circumference fell at weeks 4 and 8 and hip at week 8 compared with the start in obese adults.
Results
Weight and fat loss reported in several short trials; independent confirmation is missing.
Effect sizes as reported
Weight -5.19 kg (95% CI -8.82 to -1.55; blends, meta-analysis); weight -5.8 percent and body fat -10.9 percent (2025 single trial)
Why this rating
The pooled weight result is for combination products and rests on a few small trials by the same group. The 2025 trial has very large, tightly correlated effects, no side effects reported in the abstract, and a semaglutide comparison that should be treated with caution. Reviewers' own GRADE was high for weight, but we rate the whole picture low until others repeat it. Funding was not stated in most abstracts; any link to the branded extract CQR-300 was NOT verified.
Form and dose studied
Cissus-only extract in the 2025 and 2008 trials; blends in the meta-analysis. Amounts are not given on this page.
Who was studied
Overweight and obese adults, aged about 19 to 50.
Limits
Abstracts only. Short trials (8 to 16 weeks). Most come from the same research group. The 2021 waist result is compared with baseline, not placebo, in the abstract.
Why researchers looked
Cissus is sold as a weight-loss ingredient, often as a named extract such as CQR-300, so trials have tested it for weight and appetite.
Traditional use
Not a traditional use in the sources read; marketed in modern supplements.
Proposed mechanism Human data
A 2025 trial reports higher GLP-1 (a fullness hormone) and lower DPP-4 activity; a 2021 study reports a fat-cell gene (UCP1) switched on in human fat cells in the lab. These are proposed pathways, not proof.
A proposed mechanism does not show that the effect happens in people.
Weight-loss supplements can interact with diabetes medicines; see the Safety tab. Not a replacement for medical weight care.
Cholesterol, blood sugar and metabolic syndrome
Low certaintyThe same weight trials report lower cholesterol, triglycerides and fasting blood sugar. Because these come from blends and small trials, they should be seen as early signals.
4 studiesAmounts are not given on this page.
Studies, doses and limits
What the trials found
2017 meta-analysis (combination products): LDL cholesterol -14.43 mg/dL, triglycerides -37.50, total cholesterol -50.50, fasting blood sugar -10.39 mg/dL, each versus placebo (confidence intervals in the abstract all exclude zero). 2006 trial (123 people, 8 weeks): significant reductions in fasting glucose, total cholesterol, LDL, triglycerides and C-reactive protein with a Cissus formulation. 2008 trial: lower total and LDL cholesterol and fasting glucose than placebo. 2025 trial: fasting glucose and blood fat changes reported (p < 0.05).
Results
Lower cholesterol, triglycerides and fasting glucose in small trials, mainly with blends.
Effect sizes as reported
LDL -14.43, triglycerides -37.50, total cholesterol -50.50, fasting glucose -10.39 mg/dL (blends, pooled)
Why this rating
Pooled estimates are for combination products and a handful of small trials; no hard outcomes such as heart attacks were measured.
Form and dose studied
Amounts are not given on this page.
Who was studied
Overweight and obese adults, some with metabolic syndrome.
Limits
Abstracts only. Biomarker changes are not health outcomes. A lower fasting glucose also matters for safety because of possible low blood sugar with diabetes drugs.
Why researchers looked
Weight, blood fats and blood sugar tend to move together in metabolic syndrome, so trials measure all of them.
Proposed mechanism Preliminary mechanism
Not established in people.
A proposed mechanism does not show that the effect happens in people.
May add to the sugar-lowering effect of diabetes medicines; see the Safety tab.
Blood sugar (animal study)
Not enough evidenceA mouse study of a Cissus extract found lower blood glucose. No human trial of Cissus in diabetes was found.
1 studiesNot applicable.
Studies, doses and limits
What the trials found
Frontiers in Pharmacology 2024: Cissus extract lowered blood glucose in type 2 diabetic db/db mice (from our earlier summary; not re-opened). The record lists some authors as employed by companies. No human trial in people with diabetes was found.
Results
No human evidence.
Effect sizes as reported
Not available.
Why this rating
Animal study only.
Limits
Mouse results rarely carry over to people.
Why researchers looked
Cissus is sometimes linked to diabetes and weight loss, so lab work tests the blood sugar pathways.
Proposed mechanism Animal research
The mouse paper describes effects on liver sugar production (gluconeogenesis).
A proposed mechanism does not show that the effect happens in people.
Do not use in place of diabetes treatment.
Hemorrhoids
Evidence againstA large three-hospital trial of 570 people found no difference between Cissus, a standard flavonoid drug and placebo for acute hemorrhoids.
2 studiesAmounts are not given on this page.
Studies, doses and limits
What the trials found
2010 randomised double-blind trial (570 people, 7 days): improvement in all groups with no significant difference between Cissus, micronised purified flavonoid fraction and placebo; no adverse events or blood chemistry changes reported. The 2017 meta-analysis agreed: hemorrhoid symptoms were not different from comparators.
Results
No benefit over placebo.
Effect sizes as reported
No significant difference between groups.
Why this rating
Large double-blind trial and the meta-analysis agree there is no benefit over placebo in the short term.
Form and dose studied
Amounts are not given on this page.
Who was studied
Adults with acute hemorrhoids.
Limits
Seven days only; long-term preventive use was not tested.
Why researchers looked
Cissus has been used for hemorrhoids in some practices, so it has been tested.
Traditional use
Folk use (not verified here).
Proposed mechanism Pharmacological theory
Not established.
A proposed mechanism does not show that the effect happens in people.
No adverse events reported in that trial.
Hormone-like effects (lab and animal only)
Not enough evidenceSome Cissus parts are said to contain plant steroids and a friedelin fraction showed estrogen-like effects in rats. No trial in people measured sex hormones, so whether Cissus affects them is unknown.
3 studiesNot applicable.
Studies, doses and limits
What the trials found
No human sex-hormone data were found. The only hormone result in people is the raised parathyroid hormone in the 2025 meta-analysis (a calcium-control hormone, not a sex hormone). Rat studies: Aswar 2010 (friedelin-rich fraction, ovariectomised rats, 8 weeks, estrogen-like effects reported) and Jadhav 2016 (ketosteroid-standardised extracts in castrated male rats; ketosteroid content not linked to the bone effect).
Results
No human evidence.
Effect sizes as reported
Not available.
Why this rating
Animal data only, mostly on isolated fractions rather than whole Cissus.
Limits
Lab and animal results; the rat studies used fractions, not the supplements people buy. We read only part of the Aswar abstract.
Why researchers looked
Plant steroids ("ketosterones") are often used to market Cissus, including to people interested in muscle building and in bone health after menopause.
Proposed mechanism Animal research
A friedelin-rich fraction showed estrogen-like activity in ovary-removed female rats. A separate rat study found that "ketosteroid" content did not predict the bone effect, and the authors found no report of androgenic (male-hormone-like) steroids in the plant.
A proposed mechanism does not show that the effect happens in people.
People with hormone-sensitive conditions should ask a doctor first; see the Safety tab.
Connections to the rest of health
How Cissus connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.
Explore every connection: goals, body systems, organs, symptoms, genes
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Bone Health | Potential benefit | Low certainty | Fracture healing: Cissus is known as the "bone setter", but good evidence that it speeds up healing is thin. Reviewers found a possible benefit for fractures and bone pain, rated low certainty, and the fracture trials we found used blends with other herbs and were not blinded. Bone density after menopause: In the one placebo-controlled trial in women with early bone thinning (osteopenia), bone density after 24 weeks was no different from placebo, although a bone-building marker was lower. | 14 8 13 2 |
| Mobility Support | Potential benefit | Low certainty | Fracture healing: Cissus is known as the "bone setter", but good evidence that it speeds up healing is thin. Reviewers found a possible benefit for fractures and bone pain, rated low certainty, and the fracture trials we found used blends with other herbs and were not blinded. Joint pain in exercise-trained men: In a small trial with no placebo group, exercise-trained men with joint pain reported lower pain scores after 8 weeks. Without a comparison group this cannot show that Cissus caused the change. | 14 8 13 3 |
| Bone Health | Very low certainty | Bone blood markers (parathyroid hormone): A 2025 pooled analysis found Cissus raised parathyroid hormone, a hormone that controls calcium, but not calcium, phosphorus or alkaline phosphatase. Certainty was very low. | 9 | |
| Womens Wellness | Potential benefit | Low certainty | Bone density after menopause: In the one placebo-controlled trial in women with early bone thinning (osteopenia), bone density after 24 weeks was no different from placebo, although a bone-building marker was lower. | 2 |
| Joint Support | Potential benefit | Very low certainty | Joint pain in exercise-trained men: In a small trial with no placebo group, exercise-trained men with joint pain reported lower pain scores after 8 weeks. Without a comparison group this cannot show that Cissus caused the change. | 3 |
| Joint Support | Not enough evidence | Osteoarthritis and joint damage: We found no randomised trial of Cissus for knee or hip osteoarthritis in people. The joint findings we found were in rats and cells, which cannot show a benefit in people. | 3 | |
| Bone Health | Traditional use | Not enough evidence | Traditional "bone setter" use: In Ayurvedic and folk practice the stem has long been taken for fractures and sore joints, which is where the names hadjod and bone setter come from. This tradition is not the same as trial proof. | |
| Weight Management | Potential benefit | Low certainty | Weight and body fat: Several trials, mostly from one research group in Cameroon, report weight and fat loss with Cissus extracts or blends. Pooled results look good for blends but come from a few small trials, and the newest one needs independent repeating. | 14 16 11 10 4 |
| Metabolic Health | Potential benefit | Low certainty | Weight and body fat: Several trials, mostly from one research group in Cameroon, report weight and fat loss with Cissus extracts or blends. Pooled results look good for blends but come from a few small trials, and the newest one needs independent repeating. Cholesterol, blood sugar and metabolic syndrome: The same weight trials report lower cholesterol, triglycerides and fasting blood sugar. Because these come from blends and small trials, they should be seen as early signals. | 14 16 11 10 4 |
| Blood Sugar Balance | Potential benefit | Low certainty | Cholesterol, blood sugar and metabolic syndrome: The same weight trials report lower cholesterol, triglycerides and fasting blood sugar. Because these come from blends and small trials, they should be seen as early signals. | 14 10 11 16 |
| Cholesterol Balance | Potential benefit | Low certainty | Cholesterol, blood sugar and metabolic syndrome: The same weight trials report lower cholesterol, triglycerides and fasting blood sugar. Because these come from blends and small trials, they should be seen as early signals. | 14 10 11 16 |
| Blood Sugar Balance | Not enough evidence | Blood sugar (animal study): A mouse study of a Cissus extract found lower blood glucose. No human trial of Cissus in diabetes was found. | 6 | |
| Preventive Wellness | Evidence against | Hemorrhoids: A large three-hospital trial of 570 people found no difference between Cissus, a standard flavonoid drug and placebo for acute hemorrhoids. | 12 14 | |
| Hormone Balance | Not enough evidence | Hormone-like effects (lab and animal only): Some Cissus parts are said to contain plant steroids and a friedelin fraction showed estrogen-like effects in rats. No trial in people measured sex hormones, so whether Cissus affects them is unknown. | 1 5 9 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Bones Joints Muscles | Biological association | Low certainty | Studied for: Fracture healing Studied for: Bone blood markers (parathyroid hormone) | 14 8 13 9 2 3 |
| Hormone Health | Biological association | Very low certainty | Studied for: Bone blood markers (parathyroid hormone) Studied for: Hormone-like effects (lab and animal only) | 9 1 5 |
| Pain Inflammation | Biological association | Very low certainty | Studied for: Joint pain in exercise-trained men | 3 |
| Metabolism Weight | Biological association | Low certainty | Studied for: Weight and body fat Studied for: Cholesterol, blood sugar and metabolic syndrome | 14 16 11 10 4 |
| Blood Sugar Support | Biological association | Low certainty | Studied for: Cholesterol, blood sugar and metabolic syndrome Studied for: Blood sugar (animal study) | 14 10 11 16 6 |
| Cardiovascular System | Biological association | Low certainty | Studied for: Cholesterol, blood sugar and metabolic syndrome | 14 10 11 16 |
| Digestive System | Biological association | Evidence against | Studied for: Hemorrhoids | 12 14 |
D. Symptoms
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Hypoglycemia | Drug or supplement interaction | Not enough evidence | Reasoned risk with diabetes medicines; no study. Preparation or compound: Stem extracts and blends |
14 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Parathyroid hormone (PTH) | Biological association | Very low certainty | Measured in trials: raised. A lab change is not the same as a health benefit. | 9 |
| Bone mineral density (BMD) | Biological association | Low certainty | Measured in trials: no change. A lab change is not the same as a health benefit. | 2 |
| P1NP (bone-formation marker) | Biological association | Low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 2 |
| CTX (bone-breakdown marker) | Biological association | Low certainty | Measured in trials: no change. A lab change is not the same as a health benefit. | 2 |
| Calcium, phosphorus and alkaline phosphatase | Biological association | Very low certainty | Measured in trials: no change. A lab change is not the same as a health benefit. | 9 |
| WOMAC joint score | Biological association | Very low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 3 |
| Radius Union Scoring System (RUSS) | Biological association | Low certainty | Measured in trials: raised. A lab change is not the same as a health benefit. | 8 |
| Body weight | Biological association | Low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 14 16 |
| Body fat | Biological association | Low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 16 11 |
| Waist and hip circumference | Biological association | Low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 4 10 |
| GLP-1 and DPP-4 activity | Biological association | Low certainty | Measured in trials: mixed. A lab change is not the same as a health benefit. | 16 |
| LDL cholesterol, triglycerides, total cholesterol | Biological association | Low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 14 10 |
| Fasting blood glucose | Biological association | Low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 14 10 |
J. Genes, receptors and enzymes
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| UCP1 (uncoupling protein 1) | Preliminary mechanism | In vitro | Fat-cell browning in human fat cells in the lab. | 4 |
K. Biological pathways
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Ketosteroids (3-ketosteroids, 'ketosterones') | Biological association | Animal | Used to standardise extracts; a 2016 rat study found ketosteroid content did not predict the bone effect and found no report of androgenic steroids in the plant. Preparation or compound: Stem (per product marketing) |
5 |
| Beta-sitosterol | Biological association | Not verified | Common plant sterol; its content in Cissus was NOT verified in a source read here. Preparation or compound: Stem |
18 |
| Friedelin | Biological association | Animal | A friedelin-rich fraction acted estrogen-like in rats. Preparation or compound: Stem |
1 18 |
| Resveratrol | Biological association | Not verified | Stilbenes are named in descriptions of Cissus, but this was NOT verified in a source read here. Preparation or compound: Stem |
18 |
| Piceatannol | Biological association | Not verified | A resveratrol relative; presence in Cissus NOT verified here. Preparation or compound: Stem |
18 |
| Quercetin | Biological association | Not verified | Common flavonol; a separate paper on quercetin-rich Cissus fractions exists but was not read. Preparation or compound: Stem |
18 |
Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).
The evidence
The research centre for Cissus. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).
How we rate evidence
High certainty
Several well-run trials or reviews agree; further research is unlikely to change the picture much.
Moderate certainty
Good trials point the same way, but some doubt remains.
Low certainty
Small, short or inconsistent trials. The finding could change with better research.
Very low certainty
Very little or very weak human data. Treat as a possibility only.
Mixed findings
Trials or reviews disagree with each other.
Not enough evidence
Not enough human research to say either way.
Evidence against
Good research found no benefit, or found harm.
We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We started from our existing Cissus summary, read PubMed abstracts for the main studies, and checked the GBIF accepted name and PubChem records. Regulator pages could not be read. Only abstracts were read. Certainty ratings are the compiler's reading unless a review's own rating is quoted. No study is cited that we could not verify.
Study library: every study we checked 20
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Aswar 2010 Estrogenic activity of friedelin rich fraction (IND-HE) separated from Cissus quadrangularis and its effect on female sexual function. Pharmacognosy Research · PMID 21808556 · DOI |
Animal research animal |
Ovariectomised female rats, 8 weeks, friedelin-rich fraction | Methods, limits and fundingFunding and conflicts: Not stated in the abstract. Read: abstract | |
| Benjawan 2022 The effect of Cissus quadrangularis L. on delaying bone loss in postmenopausal women with osteopenia: A randomized placebo-controlled trial. Phytomedicine · PMID 35523116 · DOI |
Controlled trial |
134 enrolled postmenopausal women with osteopenia (108 completed), 24 weeks | Methods, limits and fundingFunding and conflicts: Not stated in the abstract read. Read: abstract | |
| Bloomer 2013 Cissus quadrangularis reduces joint pain in exercise-trained men: a pilot study. The Physician and Sportsmedicine · PMID 24113700 · DOI |
Case series |
29 exercise-trained men aged 20 to 46 with exercise-related joint pain, 8 weeks | Methods, limits and fundingFunding and conflicts: Not stated in the abstract read. Read: abstract | |
| Chatree 2021 Cissus Quadrangularis enhances UCP1 mRNA, indicative of white adipocyte browning and decreases central obesity in humans in a randomized trial. Scientific Reports · PMID 33479386 · DOI |
Controlled trial |
Obese adults, 8 weeks (size not given in the abstract), plus human fat-cell experiments | Methods, limits and fundingFunding and conflicts: No competing interests declared. Read: abstract | |
| Jadhav 2016 Ketosteroid Standardized Cissus quadrangularis L. Extract and its Anabolic Activity: Time to Look Beyond Ketosteroid? Pharmacognosy Magazine · PMID 27279709 · DOI |
Animal research animal |
Castrated (orchidectomised) male rats given Cissus extracts | Methods, limits and fundingFunding and conflicts: Not stated in the abstract. Read: abstract | |
| Kim 2024 Anti-hyperglycemic effects of Cissus quadrangularis extract via regulation of gluconeogenesis in type 2 diabetic db/db mice Frontiers in Pharmacology · PMID 39050759 · DOI |
Animal research animal |
Type 2 diabetic db/db mice | Methods, limits and fundingFunding and conflicts: Some authors were employed by companies (NUON Co., Ltd.; EveryH Co., Ltd.) per the conflict statement read; the study says no commercial relationships influenced it. Read: summary-only | |
| Kulkarni 2020 Cissus quadrangularis-Induced Thrombocytopenia in a Renal Allograft Recipient. Experimental and Clinical Transplantation · PMID 29957161 · DOI |
Case report |
One elderly kidney-transplant recipient taking azathioprine and prednisolone, who took Cissus capsules for backache | Methods, limits and fundingFunding and conflicts: Not applicable. Read: abstract | |
| Mungara AVVP 2026 CL16019, A Combination of Cissus quadrangularis and Boswellia serrata Extracts Promotes the Healing of Distal Radius Fractures: A Multicentric, Randomized, Open-Label Study. Journal of Integrative and Complementary Medicine · PMID 41896193 · DOI |
Controlled trial |
50 adults aged 30 to 50 with wrist (distal radius) fractures, 60 days | Methods, limits and fundingFunding and conflicts: No competing financial interests declared; the trial tested a named product (CL16019). Read: abstract | |
| Na Takuathung 2025 The effects of Cissus quadrangularis on bone-related biomarkers in humans: a systematic review and meta-analysis. BMC Complementary Medicine and Therapies · PMID 40707943 · DOI |
Meta-analysis |
7 randomised studies, 354 participants | Methods, limits and fundingFunding and conflicts: No competing interests declared; PROSPERO CRD42023435351. Read: abstract | |
| Oben 2006 The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome. Lipids in Health and Disease · PMID 16948861 · DOI |
Controlled trial |
123 overweight or obese adults, 8 weeks, Cameroon | Methods, limits and fundingFunding and conflicts: Funding not stated in the abstract. Industry link (branded formulation) NOT verified. Read: abstract | |
| Oben 2008 The use of a Cissus quadrangularis/Irvingia gabonensis combination in the management of weight loss: a double-blind placebo-controlled study. Lipids in Health and Disease · PMID 18377661 · DOI |
Controlled trial |
72 overweight or obese adults, 10 weeks, three groups of 24 | Methods, limits and fundingFunding and conflicts: Funding not stated in the abstract. Industry link NOT verified. Read: abstract | |
| Panpimanmas 2010 Experimental comparative study of the efficacy and side effects of Cissus quadrangularis L. (Vitaceae) to Daflon (Servier) and placebo in the treatment of acute hemorrhoids. Journal of the Medical Association of Thailand · PMID 21344797 |
Controlled trial |
570 people with acute hemorrhoids, 7 days, three hospitals | Methods, limits and fundingFunding and conflicts: Not stated in the abstract. Read: abstract | |
| Pg 2023 Comparison of Teriparatide and Combination of Cissus Quadrangularis and Dalbergia Sissoo on Bone Healing Against the Control Group in Maxillofacial Fractures: A Randomized Open-label Control Trial. Craniomaxillofacial Trauma & Reconstruction · PMID 36824186 · DOI |
Controlled trial |
24 adults with jaw fractures, 8 per group, 4 weeks of treatment | Methods, limits and fundingFunding and conflicts: No conflicts declared. Read: abstract | |
| Sawangjit 2017 Efficacy and Safety of Cissus quadrangularis L. in Clinical Use: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Phytotherapy Research · PMID 28165166 · DOI |
Meta-analysis |
9 studies, 1108 patients (hemorrhoids, bone fractures and pain, overweight and obesity) | Methods, limits and fundingFunding and conflicts: Not stated in the abstract. Read: abstract | |
| Syed 2023 Evaluation of mutagenic, cytotoxic, mitochondrial dysfunction, apoptotic activity, and acute toxicity of ethanolic extract of Cissus quadrangularis. Toxicology · PMID 36370889 · DOI |
Laboratory research in-vitro |
Human liver (HepG2) cells, bacteria (Ames test) and rats given a single 2000 mg/kg dose | Methods, limits and fundingFunding and conflicts: No competing interests declared. Read: abstract | |
| Youovop 2025 Effects of Dichrostachys glomerata and Cissus quadrangularis Extracts on GLP-1 Secretion and DPP-4 Activity in Overweight and Obese Individuals: A Randomized Controlled Trial. Medicina (Kaunas) · PMID 41597327 · DOI |
Controlled trial |
248 adults with BMI 25 to 34.9, 16 weeks, in Cameroon | Methods, limits and fundingFunding and conflicts: No conflicts declared in the record. Authors include J. Oben, who also led the 2006 and 2008 Cissus weight trials; any branded-product link was NOT verified. Read: abstract | |
| s-gbif-cissus GBIF backbone: Cissus quadrangularis L. · Source |
Registry or database n/a |
Methods, limits and fundingRead: full-record | ||
| s-pubchem-cissus PubChem compound records: beta-sitosterol, resveratrol, piceatannol, friedelin, quercetin · Source |
Registry or database n/a |
Methods, limits and fundingRead: full-record | ||
| s-regulators-none Regulator and database checks for Cissus (EMA/HMPC, NCCIH, LiverTox, LactMed) · Source |
Registry or database n/a |
Methods, limits and fundingRead: not-found | ||
| s-rxlist-cissus RxList (consumer drug reference): Cissus Quadrangularis · Source |
Authoritative guidance n/a |
Methods, limits and fundingRead: summary-only |
What we do not know yet
- No placebo-controlled trial of plain Cissus for fractures.
- Weight trials mostly from one research group; independent repeats missing.
- Funding and any link to branded extract CQR-300 not verified.
- No controlled osteoarthritis trial.
- No interaction studies or human data on pregnancy, breastfeeding or liver.
- No EMA, NCCIH, LiverTox or LactMed entry could be read.
- Steroid, phytosterol and stilbene content not verified.
How new research is added
New studies are found by a saved PubMed search and placed into the data files, then this page is rebuilt.
Lab markers
What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".
Metabolic 2
Body weight
Lowered in trials
Total body mass; in trials, usually measured at the start and end.
Low certaintyResults and what it means
Statistical vs. clinical meaning
Weight change is a useful outcome but these trials are short and from one main group.
Safety implication
Pair with medical advice; weight-loss supplements are not a replacement for care.
Fasting blood glucose
Lowered in trials
Blood sugar after not eating.
Low certaintyResults and what it means
Statistical vs. clinical meaning
Small fall; mainly relevant as a safety signal with diabetes medicines.
Safety implication
May add to sugar-lowering drugs; see the Safety tab.
Other 11
Parathyroid hormone (PTH)
Raised in trials
A hormone from the parathyroid glands that controls blood calcium and bone turnover.
Very low certaintyResults and what it means
Statistical vs. clinical meaning
A lab number, not a health outcome. A raised level is not a bone benefit.
Safety implication
Anyone with kidney, calcium or parathyroid problems should ask a doctor before use.
| Study | Result | People | Product |
|---|---|---|---|
| 9 | SMD 1.23 (95% CI 0.79 to 1.67; p < 0.0001) | 7 randomised studies, 354 participants | Cissus quadrangularis vs control |
Bone mineral density (BMD)
No change in trials
How much mineral is packed into bone, measured by a scan; low values mean weaker bone.
Low certaintyResults and what it means
Statistical vs. clinical meaning
The main outcome of the one placebo-controlled trial was negative.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 2 | No difference from placebo at lumbar spine, femoral neck or total hip at 24 weeks | 108 postmenopausal women with osteopenia finished | Cissus capsules vs placebo, 24 weeks |
P1NP (bone-formation marker)
Lowered in trials
A blood marker of new bone being laid down.
Low certaintyResults and what it means
Statistical vs. clinical meaning
Authors read this as slower bone remodeling; a lower formation marker is not by itself good or bad.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 2 | Lower than placebo at 24 weeks (higher group -9.95 +/- 22.22 percent; p < 0.01); placebo group rose | 134 enrolled, 108 finished | Cissus vs placebo |
CTX (bone-breakdown marker)
No change in trials
A blood marker of old bone being broken down.
Low certaintyCalcium, phosphorus and alkaline phosphatase
No change in trials
Routine blood bone-chemistry tests.
Very low certaintyWOMAC joint score
Lowered in trials
A questionnaire on joint pain, stiffness and function; lower is better.
Very low certaintyRadius Union Scoring System (RUSS)
Raised in trials
An X-ray score of how well a wrist fracture is healing; higher means more healed.
Low certaintyResults and what it means
Statistical vs. clinical meaning
Open-label trial of a combination product; cannot be credited to Cissus alone.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 8 | 7.96 +/- 0.20 versus 5.54 +/- 1.77 with standard care alone (p < 0.0001) | 50 adults with wrist fractures | CL16019 (Cissus plus Boswellia) plus standard care for 60 days |
Body fat
Lowered in trials
Percent of body mass that is fat.
Low certaintyResults and what it means
Statistical vs. clinical meaning
Large reported change in the newest trial; needs independent repeat.
Safety implication
None specific.
Waist and hip circumference
Lowered in trials
Tape measurements of central obesity.
Low certaintyResults and what it means
Statistical vs. clinical meaning
Tape measures are simple but depend on who measures.
Safety implication
None specific.
GLP-1 and DPP-4 activity
Mixed results in trials
GLP-1 is a gut hormone that makes people feel full; DPP-4 is an enzyme that breaks it down.
Low certaintyResults and what it means
Statistical vs. clinical meaning
One trial; the abstract compares the effect to semaglutide, which should be treated with caution.
Safety implication
No side effects were reported in the abstract; safety is unknown from this source.
| Study | Result | People | Product |
|---|---|---|---|
| 16 | GLP-1 +42.2 pg/mL and DPP-4 activity -17.8 percent versus placebo (p < 0.01) | 248 adults | Cissus extract vs placebo and semaglutide |
LDL cholesterol, triglycerides, total cholesterol
Lowered in trials
Blood fats linked to heart risk.
Low certaintyResults and what it means
Statistical vs. clinical meaning
Lab numbers, not heart outcomes.
Safety implication
None specific.
Safety
What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.
Main points to know 5
- It may lower blood sugar and add to diabetes medicines. Weight trials of Cissus blends found fasting blood sugar about 10 mg/dL lower than placebo, and a consumer drug reference warns that Cissus may lower blood sugar and advises stopping it at least 2 weeks before scheduled surgery for this reason. Combining it with insulin or diabetes tablets could push sugar too low. No interaction study exists. Pharmacological theory 14 20
- Unusually low platelets were reported in one person. A transplant patient taking azathioprine and prednisolone developed low platelets (thrombocytopenia) after taking Cissus capsules for backache, and platelets returned to normal after stopping. One case cannot show cause and the patient took other medicines. No study has tested Cissus with blood thinners. Case report 7
- Hormone effects are unknown in people. A friedelin-rich Cissus fraction acted estrogen-like in rats, and the 2025 meta-analysis found raised parathyroid hormone in people. No human study measured sex hormones. A rat study found no report of male-hormone-like (androgenic) steroids in the plant despite the common marketing claim, so claims about muscle-building hormones are not supported. Animal research 1 5 9
- Pregnancy and breastfeeding: not enough information. A consumer drug reference says there is not enough reliable information and advises avoiding use. We found no human pregnancy or breastfeeding study, and no LactMed entry was read. Authoritative guidance 20 19
- Short-term side effects look mild, but data are limited. The 2017 meta-analysis reported no serious adverse effects, and in the 24-week osteopenia trial side effects did not differ from placebo. A consumer reference lists headache, gas, dry mouth, diarrhoea and trouble sleeping for use up to 6 to 8 weeks. The 2025 weight trial abstract does not report side effects. Meta-analysis 14 2 20 16
Side effects 4
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Stomach and bowel upset (gas, diarrhoea) From a consumer drug reference (carried over from our earlier summary, not re-opened). No frequency given. The osteopenia trial found no more side effects than placebo. | Not established | mild (as listed) Not studied | Authoritative guidance 20 |
| Headache, dry mouth, trouble sleeping Listed with use up to 6 to 8 weeks; the source is a consumer reference, not a regulator. | Not established | mild (as listed) Not studied | Authoritative guidance 20 |
| Low platelet count (thrombocytopenia) Single case in a kidney transplant recipient on immune-suppressing drugs; cause not proven. | Not established | unknown; platelets recovered after stopping Platelets returned to normal after stopping in the one case | Case report 7 |
| Low blood sugar when combined with diabetes drugs Reasoned from small blood sugar falls in trials and from consumer reference advice; no study of the combination. | Not established | unknown Not studied | Pharmacological theory 14 20 |
Liver
No LiverTox entry could be read (the page was blocked by a bot check) and we found no human report of liver injury from Cissus. In the lab, an ethanol extract was not toxic to human liver cells at the lower doses tested, was not mutagenic, and did not change liver tests in rats after a single large dose; higher doses were toxic to cells. These are lab and animal findings only. We did not read any trial liver-test data. 15 19
How often. No frequency is available.
Monitoring. No agency advice found. Anyone with yellow skin or eyes, dark urine or unusual tiredness after starting a supplement should stop it and see a doctor.
This is a safety connection. It is not evidence that Cissus supports liver health.
Medicines and supplements 6
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Insulin, sulfonylureas, metformin and other diabetes medicines prescription | Cissus products may lower blood sugar, which could add to the drug effect. | Possible low blood sugar; size unknown. Pooled blend trials showed a fall of about 10 mg/dL in fasting sugar. | Pharmacological theory Not enough evidence 14 20 | If you take diabetes medicine, ask a doctor or pharmacist before using Cissus and check your sugar as advised. |
| Anticoagulants and antiplatelet drugs (warfarin, apixaban, aspirin, clopidogrel) prescription | Not established. A single case linked Cissus to low platelets, which could matter for bleeding. | Unknown. No study of Cissus with blood thinners was found. | Case report Not enough evidence 7 20 | Tell your doctor or pharmacist if you take blood thinners or have a bleeding disorder, and stop before surgery as a consumer reference advises. |
| Immune-suppressing drugs (azathioprine, prednisolone) prescription | Not established; one transplant patient on these drugs developed low platelets after Cissus. | Unknown; one case. | Case report Not enough evidence 7 | People with transplants or on immune suppressants should not add Cissus without their transplant team. |
| Blood pressure medicines prescription | No source found. | Unknown. Heart rate and blood pressure did not change significantly in the 8-week athlete pilot. | Pharmacological theory Not enough evidence 3 | No evidence of an interaction was found; ask a pharmacist if you take blood pressure medicine. |
| Hormone therapy, hormone-blocking drugs, or conditions affected by estrogen prescription | A friedelin-rich fraction acted estrogen-like in rats; whole supplements and people have not been tested. | Unknown. | Animal research Not enough evidence 1 | Ask a doctor first if you have a hormone-sensitive condition or take hormone treatment. |
| Other weight-loss or blood-sugar supplements and GLP-1 drugs supplement | The 2025 trial reports higher GLP-1 with Cissus; combining with other agents has not been studied. | Unknown. | Pharmacological theory Not enough evidence 16 | Do not stack with weight-loss drugs without medical advice. |
Who should check first 7
| Situation | Advice | Evidence |
|---|---|---|
| Pregnancy and breastfeeding | Avoid; not enough reliable information (consumer reference). | Authoritative guidance 20 |
| Diabetes treated with medicine | Ask a doctor first; risk of low blood sugar. | Pharmacological theory 14 20 |
| Scheduled surgery | A consumer reference advises stopping at least 2 weeks before. | Authoritative guidance 20 |
| Bleeding disorders or blood thinners; low platelets | Ask a doctor first (single platelet case report). | Case report 7 |
| Transplant or other immune-suppressing treatment | Do not add without the transplant team. | Case report 7 |
| Hormone-sensitive conditions | Ask a doctor first; lab signal only. | Animal research 1 |
| Children | No data found; avoid unless a clinician agrees. | Authoritative guidance 19 |
Overdose, product quality and regulators
Summary. No human poisoning report was found. An ethanol extract was not mutagenic and a single large dose did not change liver tests in rats; higher doses harmed cultured liver cells.
Animal. Rats given a single large dose of an ethanol extract showed no significant change in body weight, liver weight index or liver tests.
Human doses studied. Trials ran from 8 weeks to 24 weeks; amounts are not given on this page.
High dose or long term signals. Dose-dependent cell toxicity at higher lab doses; long-term human safety is not established.
Overdose response. Not described.
Genotoxicity. Ames test negative for the ethanol extract (lab).
Supplement content varies and many products are blends. Trials show that blends (with Irvingia, Boswellia, Dalbergia) are often what is tested. Our earlier summary notes that content and quality vary. No contamination testing study was read.
Product variation and blends. Trial results come from named extracts and combinations; the same label on a shelf product may not match what was tested. Some marketing counts on a 'ketosteroid' content that a 2016 rat study found did not track the bone effect. 5 14
| Body | Action | Date |
|---|
When to get medical help
- Shaky, sweaty, confused or faint (possible low blood sugar, especially with diabetes medicines)
- Unusual bruising, nosebleeds, bleeding gums or tiny red spots on the skin (low platelets)
- Yellow skin or eyes, dark urine, severe tiredness (possible liver trouble)
- Severe stomach pain or persistent diarrhoea
- Swelling of the face or throat, rash or trouble breathing (allergic reaction)
Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.
General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.
Frequently asked questions
What is Cissus?
Does Cissus heal fractures?
Does it help bone density after menopause?
A 24-week placebo-controlled trial in 134 women found no bone density difference from placebo, although a bone-formation marker was lower.
Does Cissus help joint pain?
A small pilot of 29 exercise-trained men found about 31 percent lower pain scores, but there was no placebo group, so it is not proof.
Does Cissus help with weight loss?
Are the weight-loss trials independent?
Does Cissus contain testosterone-like steroids?
Not shown. A rat study found no report of male-hormone-like steroids in the plant and no link between ketosteroid content and the bone effect.
Does it affect hormones?
Can it interact with diabetes medicines?
Is it safe with blood thinners or after surgery?
Is it safe in pregnancy or breastfeeding?
Not enough information. A consumer reference advises avoiding it. No human study was found.
Does it harm the liver?
No human liver injury report was found and no LiverTox entry could be read. In the lab, an extract was not toxic to liver cells at lower doses.
How much should I take?
This page does not give amounts, because the evidence is too weak to set them. Ask a doctor or pharmacist, especially if you take medicines or have diabetes.
Explore by health goal
Bone HealthMobility SupportJoint SupportMetabolic HealthBlood Sugar BalanceWomens WellnessWeight ManagementCholesterol BalancePreventive WellnessHormone Balance
Editorial transparency
- Written by
- AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records and plant and chemical databases.
- Medical review
- None. This page has not been reviewed by a physician or pharmacist.
- First published
- 2026-10-25
- Last substantive update
- 2026-10-25
- How we research
- We started from our existing Cissus summary, read PubMed abstracts for the main studies, and checked the GBIF accepted name and PubChem records. Regulator pages could not be read. Only abstracts were read. Certainty ratings are the compiler's reading unless a review's own rating is quoted. No study is cited that we could not verify.
- How we rate evidence
- See "How we rate evidence" in the Evidence tab.
- Independence
- No product is promoted on this page. No affiliate links are shown.
Sources 20
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Aswar UM, Bhaskaran S, Mohan V, et al.. Estrogenic activity of friedelin rich fraction (IND-HE) separated from Cissus quadrangularis and its effect on female sexual function.. Pharmacognosy Research. 2010. PMID 21808556. DOI 10.4103/0974-8490.65507. (abstract)
- Benjawan S, Nimitphong H, Tragulpiankit P, et al.. The effect of Cissus quadrangularis L. on delaying bone loss in postmenopausal women with osteopenia: A randomized placebo-controlled trial.. Phytomedicine. 2022. PMID 35523116. DOI 10.1016/j.phymed.2022.154115. (abstract)
- Bloomer RJ, Farney TM, McCarthy CG, et al.. Cissus quadrangularis reduces joint pain in exercise-trained men: a pilot study.. The Physician and Sportsmedicine. 2013. PMID 24113700. DOI 10.3810/psm.2013.09.2021. (abstract)
- Chatree S, Sitticharoon C, Maikaew P, et al.. Cissus Quadrangularis enhances UCP1 mRNA, indicative of white adipocyte browning and decreases central obesity in humans in a randomized trial.. Scientific Reports. 2021. PMID 33479386. DOI 10.1038/s41598-021-81606-9. (abstract)
- Jadhav AN, Rafiq M, Devanathan R, et al.. Ketosteroid Standardized Cissus quadrangularis L. Extract and its Anabolic Activity: Time to Look Beyond Ketosteroid?. Pharmacognosy Magazine. 2016. PMID 27279709. DOI 10.4103/0973-1296.182177. (abstract)
- Kim JW, Jeong JS, Kim JH, et al.. Anti-hyperglycemic effects of Cissus quadrangularis extract via regulation of gluconeogenesis in type 2 diabetic db/db mice. Frontiers in Pharmacology. 2024. PMID 39050759. DOI 10.3389/fphar.2024.1415670. (summary-only)
- Kulkarni MJ, Bhat AS. Cissus quadrangularis-Induced Thrombocytopenia in a Renal Allograft Recipient.. Experimental and Clinical Transplantation. 2020. PMID 29957161. DOI 10.6002/ect.2017.0234. (abstract)
- Mungara AVVP, Shaik NR, M CK, et al.. CL16019, A Combination of Cissus quadrangularis and Boswellia serrata Extracts Promotes the Healing of Distal Radius Fractures: A Multicentric, Randomized, Open-Label Study.. Journal of Integrative and Complementary Medicine. 2026. PMID 41896193. DOI 10.1177/27683605261435781. (abstract)
- Na Takuathung M, Aisara J, Sawong S, et al.. The effects of Cissus quadrangularis on bone-related biomarkers in humans: a systematic review and meta-analysis.. BMC Complementary Medicine and Therapies. 2025. PMID 40707943. DOI 10.1186/s12906-025-04995-8. (abstract)
- Oben J, Kuate D, Agbor G, et al.. The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome.. Lipids in Health and Disease. 2006. PMID 16948861. DOI 10.1186/1476-511X-5-24. (abstract)
- Oben JE, Ngondi JL, Momo CN, et al.. The use of a Cissus quadrangularis/Irvingia gabonensis combination in the management of weight loss: a double-blind placebo-controlled study.. Lipids in Health and Disease. 2008. PMID 18377661. DOI 10.1186/1476-511X-7-12. (abstract)
- Panpimanmas S, Sithipongsri S, Sukdanon C, et al.. Experimental comparative study of the efficacy and side effects of Cissus quadrangularis L. (Vitaceae) to Daflon (Servier) and placebo in the treatment of acute hemorrhoids.. Journal of the Medical Association of Thailand. 2010. PMID 21344797. (abstract)
- Pg G, Chugh A, Chaudhry K, et al.. Comparison of Teriparatide and Combination of Cissus Quadrangularis and Dalbergia Sissoo on Bone Healing Against the Control Group in Maxillofacial Fractures: A Randomized Open-label Control Trial.. Craniomaxillofacial Trauma & Reconstruction. 2023. PMID 36824186. DOI 10.1177/19433875211067007. (abstract)
- Sawangjit R, Puttarak P, Saokaew S, et al.. Efficacy and Safety of Cissus quadrangularis L. in Clinical Use: A Systematic Review and Meta-analysis of Randomized Controlled Trials.. Phytotherapy Research. 2017. PMID 28165166. DOI 10.1002/ptr.5783. (abstract)
- Syed AA, Reza MI, Kalleti N, et al.. Evaluation of mutagenic, cytotoxic, mitochondrial dysfunction, apoptotic activity, and acute toxicity of ethanolic extract of Cissus quadrangularis.. Toxicology. 2023. PMID 36370889. DOI 10.1016/j.tox.2022.153373. (abstract)
- Youovop J, Takuissu G, Minoue R, et al.. Effects of Dichrostachys glomerata and Cissus quadrangularis Extracts on GLP-1 Secretion and DPP-4 Activity in Overweight and Obese Individuals: A Randomized Controlled Trial.. Medicina (Kaunas). 2025. PMID 41597327. DOI 10.3390/medicina62010041. (abstract)
- . GBIF backbone: Cissus quadrangularis L.. . . (full-record)
- . PubChem compound records: beta-sitosterol, resveratrol, piceatannol, friedelin, quercetin. . . (full-record)
- . Regulator and database checks for Cissus (EMA/HMPC, NCCIH, LiverTox, LactMed). . . (not-found)
- . RxList (consumer drug reference): Cissus Quadrangularis. . . (summary-only)
Where to buy
Check the label first. Whatever you buy, look for these:
- The plant part and the extract type or ratio on the label
- A standardized amount of the active compounds, where relevant
- A third-party testing mark (USP, NSF or ConsumerLab)
- Interactions: ask a pharmacist if you take medicines, are pregnant or have a medical condition
Talk to a pharmacist or doctor before you start any supplement, especially if you take medicines. See the Safety tab for interactions.
Support our free guides: as an Amazon Associate we earn from qualifying purchases. Full disclosure.
