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The Health Benefits of Cissus Quadrangularis
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A folk remedy long used for bone/joint health and weight loss
Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health.
Medically reviewed by Arno Kroner, DAOM, LAc on August 12, 2020
Arno Kroner, DAOM, LAc, is a board-certified acupuncturist, as well as an herbalist and integrative medicine doctor. He operates a private practice in Santa Monica, California.
Learn about our Medical Review Board
Arno Kroner, DAOM, LAc
Verywell / Anastasia Tretiak
Dosage and Preparation
Cissus quadrangularis (CQ) is a perennial plant of the grape family native to tropical Asia, the Middle East, and much of Africa. Extracts of the plant have long been used in folk medicine, including Ayurveda and in traditional African and Thai medicine.
Available as a dietary supplement, Cissus quadrangularis is said to offer a variety of health benefits. Among them, CQ is believed to promote the healing of broken bones and injured joints. Because of this, it is referred to as asthisamharaka ("that which prevents the destruction of bones") by the Assam people of India, Bangladesh, and Southeast Asia.
Quadrangularis is part of CQ's name because of the angular, four-sided shape of the plant's stem. CQ is also called:
Adamant creeper
Asthisamharaka (Assam)
Hadjod (Ayurveda)
Pirandai
Veld grape
In addition to promoting bone and dental health, proponents claim the herbal remedy can aid in the treatment of the following medical conditions:
Cissus quadrangularis extracts can also be found in some bodybuilding supplements, where it is considered an alternative to steroids due to its purported anabolic effects.
Despite these and other health claims, there is little evidence that CQ works in preventing or treating any medical condition. Of the research that does exist, the conclusions are often limited by small study size or the lack of appropriate measures and controls.
Cissus quadrangularis shows promise in the prevention of osteoporosis, suggests a 2011 study published in La Clinica Terapeutica. The study involved mice that were given either the osteoporosis drug raloxifene or a combination of raloxifene and a CQ extract.
While there were no significant changes in blood calcium levels after one month, the rats that were given raloxifene and the CQ extract had greater increases in cortical bone (the hard exterior portion of bone) and trabecular bone (the "spongy" interior bone) than those given raloxifene only.
In a related study published in the Journal of Cellular Biochemistry, scientists reported that human bone cells exposed to CQ in the test tube had an accelerated production of osteoblasts (the cells responsible for new bone formation).
Despite some positive findings, there has yet to be any evidence that the administration of CQ can speed bone healing or aid in the repair of bone fractures.
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Joint Pain and Arthritis
Cissus quadrangularis is believed to have anti-inflammatory properties that help relieve joint pain. Researchers from the University of Memphis tested the hypothesis in 29 young, healthy men who reported chronic joint pain as a result of strenuous exercise.
After receiving 3,200 milligrams (mg) of a CQ supplement daily for eight weeks, the men reported a subjective decrease in joint pain, swelling, and stiffness (although no clinical changes were noted). The conclusions were limited by the lack of a placebo control group and the small sample size.
A similar study in rats, published in the Journal of Ethnopharmacology, found that an alcohol-based CQ extract reduced levels of tumor necrosis factor-alpha (TNF-a), an inflammatory cytokine associated with rheumatoid arthritis and osteoarthritis.
Test tube studies have also suggested that CQ can inhibit cyclooxygenase 1 and cyclooxygenase 2 (better known as COX-1 and COX-2) enzymes in the same way that many anti-inflammatory drugs do.
Whether these effects are robust enough to provide arthritis relief in humans has yet to be proven.
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Extracts of Cissus quadrangularis may support weight loss efforts, according to a small study published in the Journal of Alternative and Complementary Medicine in 2019.
According to the researchers, a water-based extract of Cissus quandrangularis (called CQR-300) was used in 35 adults with metabolic syndrome, while a corn starch placebo was given to a matched group of 32 adults.
After eight weeks, adults given 300 mg of CQR-300 daily had an 8.9% loss in body fat versus 1.05% in the placebo group.
The CQR-300 users also experienced a drop in blood pressure, total cholesterol, triglycerides, and fasting blood glucose, as well as increases in HDL ("good") cholesterol (although these effects are attributed more to weight loss than the effects of the supplement).
Despite the positive findings, it is worth noting that corn starch hinders weight loss and that 300 grams (10 ounces) equates to about 1,000 calories.
Although Cissus quadrangularis has a long history of use as a treatment for hemorrhoids, a 2010 study published in the Journal of the Medical Association of Thailand found that it failed to aid in hemorrhoid treatment.
Among the 570 people enrolled in the study, half of whom received a topical CQ ointment for seven days, none reported any greater or lesser relief of hemorrhoids than those provided a placebo.
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Due to a lack of research, little is known about the long-term safety of Cissus quadrangularis. The herbal remedy appears to be safe for short-term use (six to 12 weeks).
Common side effects tend to be mild and may include:
Intestinal gas
There is also evidence that CQ can lower blood glucose levels and have sedative and muscle-relaxing effects at higher doses.
Cissus quadrangularis may interact with diabetes medications, causing an abnormal drop in blood sugar (hypoglycemia). If you have diabetes, it is important to advise your doctor if you are taking a CQ supplement and to regularly monitor your blood sugar for any abnormal changes.
Given the limited research on its use during pregnancy, it is best to avoid Cissus quadrangularis in any form if you are pregnant or breastfeeding.
Cissus quadrangularis is available as a dietary supplement, typically in capsule form in doses ranging from 500 to 1,000 mg. There are also CQ powders you can add to protein drinks and juices.
There is no universal guideline as to the appropriate use of Cissus quadrangularis. Various studies have suggested that it can be used safely in doses as high as 3,200 mg per day, although studies were generally limited to around eight weeks.
Due to the lack of research, CQ supplements should not be used on an ongoing basis to prevent osteoporosis as calcium or vitamin D supplements might be.
Cissus quadrangularis is rarely sold fresh outside of Southeast Asia as it is difficult to grow and tends to thrive in indigenous environments.
Because dietary supplements aren't strictly regulated in the United States, their quality and safety can vary from one brand to the next. This is especially true of imported traditional remedies which have been known to sometimes be tainted with heavy metals, animal byproducts, pesticides, and drugs.
To better ensure quality and safety, opt for well-known supplement brands that are more likely to contain the amount of ingredient listed on the product label.
Better yet, check the label to see if the supplement has been tested by an independent certifying body like U.S. Pharmacopeia (USP), ConsumerLab, or NSF International. Such a stamp of approval does not mean that the supplement is safe or effective, only that it contains the listed ingredients in the correct amounts.
As a rule of thumb, avoid brands that make overt health claims or promises of cures. Not only is this illegal, but it should serve as a warning that the manufacturer—and their product—may be less than trustworthy.
Know the 5 Signs of Medical Quackery
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Stohs SJ, Ray SD. A review and evaluation of the efficacy and safety of Cissus quadrangularis extracts. Phytother Res. 2012 Aug;27(8):1107-14. doi:10.1002/ptr.4846.
Bloomer RJ, Farney TM, McCarthy CG, Lee SR. Cissus quadrangularis reduces joint pain in exercise-trained men: a pilot study. Phys Sportsmed. 2013 Sep;41(3):29-35. doi:10.3810/psm.2013.09.2021.
National Center for Complementary and Integrative Health. Traditional Chinese Medicine: What You Need To Know. Bethesda, Maryland; April 29, 2019.
Bhujade AM, Talmale S, Kumar N, et al. Evaluation of Cissus quadrangularis extracts as an inhibitor of COX, 5-LOX, and proinflammatory mediators. J Ethnopharmacol. 2012 Jun 14;141(3):989-6. doi:10.1016/j.jep.2012.03.044.
Kumar R, Gupta Y, Singh S, Arunraja S. Cissus quadrangularis attenuates the adjuvant-induced arthritis by downregulating pro-inflammatory cytokine and inhibiting angiogenesis. J Ethnopharmacol. 2015 Dec 4;175:346-55. doi:10.1016/j.jep.2015.08.058.
Muthusami S, Senthilkumar K, Vignesh C, et al. Effects of Cissus quadrangularis on the proliferation, differentiation and matrix mineralization of human osteoblast-like SaOS-2 cells. J Cell Biochem. 2011 Apr;112(4):1035-45. doi:10.1002/jcb.23016.
Nash R, Azantsa B, Kuate D, et al. The Use of a Stem and Leaf Aqueous Extract of Cissus quadrangularis(CQR-300) to Reduce Body Fat and Other Components of Metabolic Syndrome in Overweight Participants. J Altern Complement Med. 2019 Jan 1;25(1):98-106. doi:10.1089/acm.2018.0016.
Panpimanmas S, Sithipongsri S, Sukdanon C, Manmee C. 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. J Med Assoc Thai. 2010 Dec;93(12):1360-7.
Potu BK, Nampurath GK, Rao MS, Bhat KM. Effect of Cissus quadrangularis Linn on the development of osteopenia induced by ovariectomy in rats. Clin Ter. 2011;162(4):307-12.
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