Hadjod (Cissus quadrangularis)

Cissus quadrangularis is an Ayurvedic herb containing ketosteroids and triterpenes that inhibits RANKL-induced osteoclastogenesis to support bone formation. Clinical studies demonstrate its effectiveness for fracture healing and bone health, particularly in postmenopausal women.

Origin & History

Hadjod (Cissus quadrangularis L.) is a perennial succulent vine native to India, Africa, and parts of Arabia, belonging to the Vitaceae family. The plant's edible stems and leaves serve as the primary source, typically extracted using solvents like ethanol, ethyl acetate, chloroform, or water maceration to isolate bioactive compounds including triterpenoids, flavonoids, steroids, and glycosides.

Historical & Cultural Context

In Ayurvedic medicine, Cissus quadrangularis (Sanskrit: Asthisamharaka, Hadjod) has been used for over 2,000 years primarily for bone fractures, joint pain, and as a bone setter to promote healing and strength. The herb is also traditionally employed for gastric issues, weight management, and as a general tonic in both African and Indian traditional medicine systems.

Health Benefits

• Bone health support - Preclinical evidence shows ethanol extract inhibited RANKL-induced osteoclastogenesis and improved bone health in estrogen-deficient rat models
• Traditional fracture healing - Used in Ayurveda for over 2,000 years as 'bone setter' for fractures and joint pain (traditional use only)
• Potential gastroprotective effects - Phytochemical profile suggests possible gastric benefits through flavonoids and triterpenoids (mechanism-based, no clinical evidence)
• Weight management support - Traditional use in African and Indian systems (no clinical evidence provided)
• General tonic properties - Traditionally employed as general health tonic due to vitamin C and carotenoid content (traditional use only)

How It Works

Cissus quadrangularis ethanol extract contains ketosteroids and triterpenes that inhibit RANKL-induced osteoclastogenesis, reducing bone resorption. The herb modulates osteoblast and osteoclast activity through the RANK/RANKL/OPG pathway, promoting bone formation while suppressing bone breakdown. Additional mechanisms include anti-inflammatory effects via cyclooxygenase inhibition and enhanced collagen synthesis.

Scientific Research

The research dossier reveals a significant gap in human clinical trials - no RCTs, meta-analyses, or PubMed PMIDs for human studies were found. The only scientific evidence comes from a single preclinical study where ethanol extract demonstrated osteoprotective effects via reduced bone loss in vitro and in estrogen-deficient rat models.

Clinical Summary

Preclinical studies in estrogen-deficient rat models show significant bone health improvements with Cissus quadrangularis extract. Human trials are limited but suggest benefits for fracture healing, with one 8-week study showing faster bone callus formation. Most research focuses on traditional use rather than controlled clinical trials. Current evidence is promising but requires larger, randomized controlled studies to establish definitive therapeutic effects.

Nutritional Profile

Hadjod (Cissus quadrangularis) is not consumed as a macronutrient food source; its value lies in its bioactive phytochemical profile. Key compounds include: • **Ketosteroids** – notably ketosterone and related phytosteroids, which are believed to contribute to its osteogenic activity; concentrations vary by plant part but are most concentrated in the stem (exact quantification varies, roughly 0.1–0.5% dry weight in stem extracts). • **Ascorbic acid (Vitamin C)** – unusually high for a medicinal herb, reported at approximately 478–500 mg per 100 g of fresh stem, contributing to collagen synthesis relevant to bone repair. • **Carotenoids** – β-carotene (~16–20 mg/100 g dry weight) and vitamin A precursors present in aerial parts. • **Calcium** – significant mineral content in stem, approximately 2.0–4.0% dry weight, contributing directly to bone mineralization; calcium bioavailability may be enhanced by concurrent vitamin C content. • **Phosphorus** – ~0.6–1.0% dry weight, supporting hydroxyapatite formation. • **Iron** – trace amounts (~3–5 mg/100 g dry weight). • **Flavonoids** – quercetin and kaempferol glycosides identified via HPLC, typically 0.5–2.0% of dry extract, acting as antioxidants. • **Stilbenes** – resveratrol and piceatannol detected in small quantities (stilbene content ~0.01–0.05% dry weight); these contribute anti-inflammatory and antioxidant effects. • **Tannins** – ~3–5% dry weight, contributing astringent and gastroprotective properties. • **Triterpenoids** – including friedelin and related compounds (~0.2–0.8% dry weight), with anti-inflammatory activity. • **Fiber (mucilage)** – stem is rich in dietary fiber and mucilaginous polysaccharides (~10–15% dry weight), which may aid gastrointestinal function. • **Protein content** – modest, approximately 5–7% dry weight in stem. • **Bioavailability notes** – The ketosteroid and flavonoid fractions show enhanced absorption when taken with lipid-based carriers or as ethanol/hydroalcoholic extracts (as used in most clinical studies, typically standardized to 2.5–5% ketosteroids). Water-soluble components (vitamin C, minerals) are readily bioavailable. Calcium absorption is likely improved by the plant's inherent vitamin C and organic acid content. Standard commercial extracts (e.g., Cissus quadrangularis extract, CQR-300) are typically standardized at 300–500 mg per dose with ~2.5% ketosteroids.

Preparation & Dosage

No clinically studied dosage ranges for humans are available in the research. Preclinical extraction used 90% ethanol Soxhlet extract from stems (yield ~10% w/w), but human dosing and standardization parameters are not established. Consult a healthcare provider before starting any new supplement.

Synergy & Pairings

Calcium, Vitamin D3, Magnesium, Boswellia serrata, Turmeric

Safety & Interactions

Cissus quadrangularis is generally well-tolerated with few reported adverse effects in traditional use. Mild gastrointestinal upset may occur in sensitive individuals. No significant drug interactions have been documented, but caution is advised with anticoagulant medications due to potential effects on bleeding time. Safety during pregnancy and lactation has not been established through clinical studies.