Cissus Quadrangularis (Hadjod)

Cissus Quadrangularis (also called Hadjod and Asthisamharaka) is an ayurvedic herb used for strengthening bones and joints and promoting bone growth. It increases bone mineral density and enhances the rate of fracture healing. In addition to its uses in bone and joint disorders, it also used to treat loss of appetite, indigestion, hemorrhoid, intestinal worms, gout, internal bleeding, and leucorrhea. It also has aphrodisiac action due to which it is also used to improve men’s stamina, vigor, and strength.

Sanskrit Name of Cissus Quadrangularis is Asthisamharaka, which means for “bone setter”. In Ayurveda, the fresh juice of Cissus Quadrangularis plant in a dosage of 20 ml twice daily is used to accelerate fracture healing rate and restoring the bone mass in several diseases including low bone mineral density and osteoporosis. The external application of a paste prepared from Hadjod Powder and warm water is also used for same purposes.

Medicinal Parts

The leaves and stem of Cissus Quadrangularis plant are main medicinal parts used for bone and joint disorders. In ayurveda, fresh juice extracted from its leaves and stem are used in most of the diseases. In powdered form, it is added in several ayurvedic formulations.

Phytochemistry (Chemical Composition)

Aerial parts of Cissus quadrangularis contain ketosteroids, freidelin, resveratrol, and Quadrangularin A as main bioactive constituents. 100 grams C. Quadrangularis contains 327 mg Vitamin C and 696 mg Vitamin E. (1)

Quercetin and Kaempferol are also present in ethanol extract of C. Quadrangularis. (2, 3)

Around 2.5% friedelin is present in the ethanolic extract of C. Quadrangularis aerial parts. (4, 5)

Methanolic extract of aerial parts of C. quadrangularis contains 0.47% stimasterol and 1.15% β-sitosterol. Ethyl acetate extract contains 0.16% stimasterol and 0.5% β-sitosterol. Stigmasterol and β-sitosterol were undetectable in water extract. (6)

It also contains acetylated glycosides of catalpol (6′-O-trans-cinnamoyl-catalpol; 6-O-m-methoxy-benzoyl catalpol, and 6-O-{2, 3-dimethoxy}-t-cinnamoyl-catalpol). It contains stilbene compounds including resveratrol glycosides, resveratrol, piceatannol, pallidol, parthenocissine A, genistein, quadrangularin A-C, and daidzein. (7, 8, 9, 10)

Medicinal Properties

Cissus Quadrangularis has following medicinal properties:

• Accelerate the rate of fracture healing
• Strengthen bones and joints
• Restore bone mass
• Anodyne – pain relieving
• Anabolic supplement (mainly for bones)
• Hemostatic (styptic) – Check bleeding
• Anti-hemorrhoid – mainly beneficial in bleeding piles
• Digestive stimulant
• Hepatoprotective
• Anthelmintic or vermifuge
• Blood detoxifier
• Aphrodisiac

In high dosage, Cissus Quadrangularis extract also shows sedative and muscle relaxing effects. (11)

Therapeutic Indications

1. Bone Fracture
2. Low bone mineral density
3. Osteoporosis
4. Osteoarthritis
5. Joint pains in athletes due to exercises
6. Gout (Hyperuricemia)
7. Rickets in children (along with Calcium and Vitamin D supplementation) – helps to strengthen the bones and promote bone growth
8. Weight Loss (Obesity) – mainly beneficial for reducing abdominal adiposity, central obesity, accumulation of fat around pelvis, belly, buttocks, and upper thighs
9. Internal Bleeding
10. Hemorrhoid – mainly bleeding piles
11. Improve Digestion
12. Syphilis
13. Menorrhagia
14. Pyorrhea & Gingivitis (gargling with Fresh Hadjod Juice)

Cissus quadrangularis Benefits & Medicinal Uses

Cissus quadrangularis has strengthening effects on bones, joint, ligaments, and muscles. It is primarily used for treating the diseases related to these structures.

Bone Fracture

Cissus Quadrangularis facilitates bone fracture healing by accelerating the proliferative physiological process in the bone. It increases the rate of bone regeneration and improves blood circulation and nutrient supply to the bone. It preserves bone tissue anabolism and regeneration and promotes osteoblastic proliferation and differentiation. (12)

In ayurvedic medicine, Lakshadi Guggul is commonly used for this purpose in which Hadjod (C. Quadrangularis) is an important ingredient. This formulation is commonly co-administered with Abha Guggul and Gandha Thailam.  The fresh juice of Hadjod stem is more effective for accelerating the fracture healing. Ayurvedic herbalists commonly use it in the dosage of 20 ml twice daily along with milk or Cow’s Ghee for hastening the recovery from bone fractures. Where fresh herb is not available, its aqueous extract or powder can also be used.

A paste prepared from Cissus Quadrangularis stem and leaves is applied on the fractured part for hastening recovery. It was commonly used during ancient times in India when there was no orthopedic (plaster) cast available. During that time, its paste was applied to fractured part or after aligning the broken bone, and then covered with a clean cloth and bind with wooden stick cover.

Osteoporosis

Cissus Quadrangularis is helpful in case of osteoporosis. It increases bone strength and restores the bone mass. It increases mineralization in the bone and promotes the formation of the mineral nodules. It promotes osteoblastic proliferation and differentiation. It increases bone mineral density (BMD) and reduces the susceptibility to bone fracture. (13, 14)

In Ayurveda, Cissus Quadrangularis juice or Hadjod powder is used along with Godanti Bhasma, Muktashukti Bhasma, Praval Bhasma, Kukkutandatvak Bhasma, Abhrak Bhasma, Yashad Bhasma, Amla, Arjuna, and Ashwagandha for treating osteoporosis. This combination helps to restore the mineralization of the bone and increase the bone strength.

Weight Loss (Obesity)

However, a study suggests Cissus Quadrangularis exhibits antioxidant and weight reducing properties. It reduces body fat and improves overall lipid profile. (15, 16)

Cissus Quadrangularis and Irvingia Gabonensis combination is also effective for reducing weight. A study found the potential synergistic effect of these herbs in the management of obesity. (17)

According to ayurvedic properties of Cissus Quadrangularis (Hadjod), it boosts metabolism and forms the bones. Weaker bones are found in obese people, according to ayurveda concept of DHATUAGNI and in reality as well. According to ayurveda, optimum MEDA (Fat) DHATUAGNI is required to form the bone. The bones are well-grown when a person has optimum MEDA DHATUAGNI. Now, modern research studies also suggest the same things, but with different words – excess fat or adipose tissue negatively affects the bone health. A low bone mineral density is commonly found in obese people. (18, 19)

According to ayurveda, Cissus Quadrangularis boosts metabolism and reduces fat mass in the body. It helps to improve MEDA DHATUAGNI that ultimately increases the bone mass and strength. It increases the weight of bones. It significantly reduces fat deposition around the pelvis, belly, buttocks, and upper thighs. In most cases, inch loss and reduction in abdominal adiposity are observed. However, it is also noted that it is less likely to reduce the overall weight of the body until your bones are weak. In ayurveda community, it is stated that it increases the weight of the bones and reduces the mass of fat. The reduction in overall body weight might not be significant until your bones are weak because the weight will be transferred to the bones. When you continue to consume cissus supplement for a long-run, then it starts reducing the overall weight of the body. It starts when your bones become stronger and they further don’t need extra nourishment for the bones and joints.

Effects on Lipid Profile –Cholesterol, Triglycerides

According to a preliminary clinical study, Cissus Quadrangularis improves metabolism and lipid profile. It reduces total cholesterol, LDL-cholesterol, and triglycerides. Further, it also increases HDL-cholesterol (good cholesterol). (20)

Joint Pain in athletes due to strenuous exercises

Cissus Quadrangularis has anodyne and anti-inflammatory actions. So, it can help to reduce joint inflammation and pain. Preliminary evidence showed improvement in joint mobility and reduction in joint pain in athletes who experienced joint pain due to strenuous exercises. (21)

Improve Digestion

The aerial parts of Cissus Quadrangularis have a digestive action. It improves digestive capacity and liver function. However, C. Quadrangularis is not commonly used for this purpose. In folk medicine, a veggie prepared from its leaves or chutney prepared from aerial parts of C. Quadrangularis is also used to improve digestion.

In traditional medicine, C. Quadrangularis stem powder is mixed with ginger powder in equal proportion and advised to take it for improving appetite.

Note:

A proprietary extract of Cissus Quadrangularis containing 2.5% ketosteroids was hypothesized for controlling appetite and helping to lose weight. (22)

However, it is not yet established fact if it actually suppresses appetite or not, but it helps reducing weight with mechanism explained in above under heading weight loss.

According to its ayurvedic properties, it is likely to increase appetite when used in a natural form. Its extract or derivatives are not suggestible in ayurveda and might not provide similar results.

Secondly, a traditional preparation used for improving appetite also contains ginger powder, which is itself a potent appetizer.

Gout (Gouty Arthritis)

Cissus Quadrangularis can be used as supportive medicine to improve joint mobility. It also helps to reduce joint inflammation and pain in patients suffering from gouty arthritis.

Syphilis

In traditional medicine, fresh stems of C. Quadrangularis are warmed keeping them in burning coals for a few minutes. Then the juice is extracted from them. 20 ml extracted juice is added in 20 ml Ghee and advised to take it after meal twice daily for 7 days. This combination helps to treat syphilis and reduces its symptoms.

Menorrhagia

(Abnormally heavy or prolonged menstrual periods)

20 ml Fresh juice of Cissus Quadrangularis stems and leaves is used along with 3 grams white sandalwood powder (Santalum Album) and 1 teaspoon honey to treat excessive bleeding occurring during menstruation.

Pyorrhea & Gingivitis

Gargling with Cissus Quadrangularis Juice helps to treat pyorrhea and reduces the inflammation of the gums. It clears plaque and tartar. It also has an antimicrobial action that prevents and stops microbial growth.

Dosage & Administration

Cissus Quadrangularis is used in various forms. The dosage of each form is described underneath:

Cissus Quadrangularis Powder Dosage

Cissus Quadrangularis Powder (also called Hadjod Churna) is prepared from dried C. Quadrangularis stems and leaves. It is a finely ground powder of this herb.

How to Take C. Quadrangularis Powder

Cissus Quadrangularis Juice

Cissus Quadrangularis Juice is also called Hadjod Svarasa. It is collected by crushing and pressing fresh stem and leaves of the plant.

How to Take C. Quadrangularis Juice

Cissus Quadrangularis Extract Dosage

The standardized extract of Cissus Quadrangularis contains 2.5% ketosteroids. It should be taken in dosage ranges from 300 to 600 mg twice daily.

How to Take C. Quadrangularis Extract

Hadjod Capsules & Tablets

There are two types of Cissus Quadrangularis tablets and capsules in name of Hadjod Capsules or Hadjod tablets are available in the market. You should check if they contain Cissus Quadrangularis extract or pure herb powder. In most cases, these supplements are advised in a dosage of 1 to 2 capsule or tablets twice daily after food. However, if they contain powder, then dosage can be increased accordingly as recommended above in the table.

Safety Profile

Cissus Quadrangularis or Hadjod in natural form (dry stem powder, fresh juice, cooked leaves, and stem) is likely safe when used in an appropriate dosage. In high dosage, it can cause some side effects especially in patients with Pitta Prakriti (Pitta Body Type) or Pitta health condition.

Cissus Quadrangularis Side Effects

Cissus Quadrangularis can cause the following side effects:

1. Dry mouth (common)
2. Feeling of increased heat (common)
3. Burning sensation
4. Sleeplessness
5. Headache
6. Restlessness
7. Vertigo
8. Excessive sweating
9. Diarrhea (rare)

Most of these side effects occur when Cissus Quadrangularis is used in extract form (unnatural form) in a dosage of more than 1200 mg, C. Quadrangularis juice in a dosage of more than 40 ml, or C. Quadrangularis powder (Hadjod Churna) in a dosage of more than 6 grams per day. According to ayurveda, people having Pitta Type Body (Pitta Prakriti) can also experience these side effects with lesser dosage. Therefore, the dosage can vary individually and you should take it under the supervision of a well-experienced doctor.