Cissus quadrangularis is a succulent climbing plant of the grape family (Vitaceae). It is known as veldt grape, as Hadjod in India and as Phet Sang Khat in Thailand. In Ayurvedic medicine it has long been used to help broken bones heal. Today its stem and leaf extracts are sold as dietary supplements for joint and bone support and for weight loss, and it is also promoted as an “anabolic.”
The human evidence is thin. Small, mostly low-quality trials hint at faster fracture healing, and several trials from one research group report weight loss. An independent trial found no effect on weight, and no study has shown that Cissus builds muscle.
This page summarizes what clinical trials, systematic reviews and regulators report. It is for education only and is not medical advice.
| Property | Detail |
|---|---|
| Class | Botanical dietary supplement (Vitaceae, grape family) |
| Other names | Veldt grape; Hadjod (India); Phet Sang Khat (Thailand) |
| Parts used | Stem, leaf and other aerial parts, as powder or extract |
| Route | Oral (capsules, powders) |
| Doses used in trials | 300 mg/day of a branded extract (weight trials); 500 mg/day to 10 g/day (bone trials); 3.2 g/day (joint-pain pilot) |
| Half-life | Not established; no human pharmacokinetic studies |
| Key fact | “Ketosteroid” standardization on labels was not linked to any effect in rats; no androgenic steroid has been identified in the plant |
| US status | Sold as a dietary supplement; not an approved drug |
| WADA status | Not named on the 2026 Prohibited List |
What it is
Cissus quadrangularis is a perennial vine with thick, four-angled stems. It grows in tropical parts of Asia and Africa. Traditional uses listed in the literature include fractures, hemorrhoids (“piles”), gout, skin disease and colic (Bafna et al., J Ethnopharmacol 2021).
Chemical analyses have found many classes of plant compounds in Cissus extracts (Stohs and Ray, Phytother Res 2013):
- plant steroids and triterpenes;
- flavonoids, such as quercetin;
- stilbenes, such as resveratrol;
- iridoids and gallic acid derivatives.
In few cases has any specific effect been tied to a specific compound. Commercial extracts therefore vary widely in what they contain and how they are standardized.
About “ketosterones.” Many supplement labels standardize Cissus to “ketosteroids” or “ketosterones,” with claimed contents in the NIH label database ranging from 2.5% to 60% (NIH DSLD). This marketing implies a steroid-like, anabolic action. A rat study that compared extracts standardized this way found that ketosteroid content did not track with the effects on body weight or bone. The authors found no report of androgenic steroids in the plant and called the “3-ketosteroid” standardization scientifically incorrect (Jadhav et al., Pharmacogn Mag 2016).
How it works in the body
No study has measured how Cissus is absorbed, distributed or eliminated in people. There is no established human half-life.
The only kinetic data come from rats. After an ethanol extract was given orally, quercetin and resveratrol from the extract were absorbed quickly and were broken down by rat liver enzymes (Dadge et al., Molecules 2023). Whether this applies to people, or to other extracts, is unknown.
Proposed mechanisms also come from animal and cell work:
- Bone, in rats: in rats with their ovaries removed (a model of postmenopausal bone loss), 3 months of Cissus feeding preserved trabecular bone in the femur and tibia but not the spine. It raised a bone-formation marker (P1NP) and lowered bone-resorption markers (Guerra et al., J Bone Miner Metab 2019).
- Fat cells, in cell culture: Cissus extract increased expression of UCP1, a marker of “browning,” in human fat cells grown in the lab (Chatree et al., Sci Rep 2021).
These findings are hypotheses for human research, not shown effects in people.
Regulatory status
In the US, Cissus quadrangularis is sold as a dietary supplement, not as an approved drug. Under the Dietary Supplement Health and Education Act (DSHEA), manufacturers are responsible for the safety and labeling of their products before sale. FDA can act against adulterated or misbranded products after they reach the market (FDA).
Cissus is not named on the WADA 2026 Prohibited List. As with any supplement, the label does not guarantee that a product is free of undeclared ingredients.
What the research shows
Two systematic reviews frame the evidence:
- A 2017 meta-analysis pooled 9 randomized trials with 1,108 patients. Cissus did not help hemorrhoids. It showed benefit for bone pain and fractures, but the fracture evidence was rated low quality. For weight, only combination products could be pooled, and these showed benefit (Sawangjit et al., Phytother Res 2017).
- A 2025 meta-analysis of 7 randomized trials (354 people) with bone conditions found that Cissus raised parathyroid hormone (PTH) but did not change calcium, phosphorus or alkaline phosphatase. The certainty of evidence was very low for every outcome (Na Takuathung et al., BMC Complement Med Ther 2025).
Fracture healing
Most fracture trials are small, open-label and done in jaw (maxillofacial) fractures. In the 2025 meta-analysis, oral doses ranged from 500 mg/day to 10 g/day for 4–24 weeks.
| Study | Design, n | Product and dose | Main result |
|---|---|---|---|
| Brahmkshatriya et al., Ayu 2015 | Controlled pilot, 9 jaw-fracture patients (5 vs 4) | 500 mg three times daily for 6 weeks, after surgical fixation | Less pain, swelling and fragment mobility; healing visible earlier on day 21 |
| Nayak and R, J Maxillofac Oral Surg 2020 | Randomized pilot, jaw fractures | Cissus vs a control group | Higher alkaline phosphatase only; no difference in X-ray density, mobility, swelling, pain, calcium or phosphorus |
| Mungara et al., J Integr Complement Med 2026 | Randomized, open-label, 50 wrist (distal radius) fractures | Cissus plus Boswellia combination for 60 days, added to standard care | X-ray union score 7.96 vs 5.54 with standard care alone (p below 0.0001) |
| Na Takuathung et al., 2025 | Meta-analysis, 7 RCTs, 354 people | 500 mg/day to 10 g/day | PTH up (SMD 1.23, 95% CI 0.79–1.67); calcium, phosphorus, ALP unchanged; very low certainty |
The wrist-fracture trial tested a two-herb product, so it cannot isolate the effect of Cissus. No large, blinded, placebo-controlled fracture trial has been published.
Bone density after menopause
A randomized, placebo-controlled trial assigned 134 postmenopausal women with osteopenia (bone density below normal but not yet osteoporosis) to Cissus 1.2 g/day, 1.6 g/day or placebo for 24 weeks; 108 completed it (Benjawan et al., Phytomedicine 2022).
- Bone mineral density: the percent change did not differ from placebo at the spine, femoral neck or total hip.
- Bone turnover: P1NP, a marker of bone formation, fell on Cissus compared with placebo (for example −9.95% on 1.6 g/day at week 24). The authors read this as slower bone remodeling.
- Safety: adverse event rates did not differ among the three groups.
Weight loss and metabolic markers
Most weight trials come from one group at the University of Yaoundé in Cameroon. Four of these trials used extracts supplied by Gateway Health Alliances, the supplier of the branded extract CQR-300, and some tested multi-ingredient formulas.
| Trial | Design, n | Product and daily dose | Duration | Reported result |
|---|---|---|---|---|
| Oben et al., 2006 | RCT, 123 | Multi-ingredient formula (Cissus plus green tea extract, soy protein, chromium, selenium, B vitamins), 514 mg twice daily | 8 weeks | Weight −3.7 to −8.1 kg across formula groups vs −2.3 kg on placebo |
| Oben et al., 2007 | RCT, 168 enrolled (153 completed) | CQR-300 300 mg/day, or a formula at 1,028 mg/day | 6–8 weeks | Greater weight loss than placebo; lower lipids and fasting glucose |
| Oben et al., 2008 | RCT, 72 | Cissus 150 mg twice daily, or Cissus plus Irvingia gabonensis | 10 weeks | Weight −8.8% on Cissus and −11.9% on the combination vs −2.1% on placebo |
| Nash et al., 2019 | RCT, 67 | CQR-300 300 mg/day | 8 weeks | Body fat −8.9% (impedance) and −12.8% (DEXA); placebo −1.05% (impedance) and no change (DEXA) |
| Youovop et al., 2025 | RCT, 248 | Cissus extract 300 mg/day (other arms: a second herb, semaglutide, placebo) | 16 weeks | Weight −5.8% and body fat −10.9% reported for Cissus |
| Chatree et al., 2021 | RCT, 30 (Thailand) | Cissus extract 600 mg/day | 8 weeks | No effect on weight, BMI, fat mass or body fat percentage; waist and hip circumference fell within the Cissus group |
The 2017 meta-analysis pooled only combination products for weight and found a mean difference of −5.19 kg versus placebo (95% CI −8.82 to −1.55), with lower LDL cholesterol, triglycerides and fasting glucose (Sawangjit et al., 2017).
A broader 2020 meta-analysis of 54 placebo-controlled trials of herbal weight-loss products noted that the 3 or fewer trials of Cissus reported statistically and clinically significant weight loss. It cautioned that these trials were few, of generally poor methodological quality and poorly reported, and concluded the evidence was insufficient to recommend any of the herbs reviewed (Maunder et al., Diabetes Obes Metab 2020).
Joint pain in trained men
In an uncontrolled pilot, 29 exercise-trained men aged 20–46 with chronic joint pain took Cissus 3,200 mg/day for 8 weeks. The total WOMAC pain-and-function score fell from 25.4 to 17.4, about 31%. Heart rate, blood pressure and blood biomarkers did not change (Bloomer et al., Phys Sportsmed 2013). Without a placebo group, this result cannot separate a drug effect from placebo response or natural improvement. The authors themselves called for a placebo-controlled study.
Hemorrhoids
A double-blind randomized trial in 570 patients with acute hemorrhoids compared Cissus, a flavonoid drug (Daflon) and placebo for 7 days. All three groups improved, with no significant differences between them (Panpimanmas et al., J Med Assoc Thai 2010).
Muscle growth and “anabolic” claims
No human trial has tested whether Cissus increases muscle mass, strength or testosterone. A 2013 review of the animal, human and cell literature stated that no studies have shown that Cissus has anabolic or bodybuilding effects (Stohs and Ray, 2013). The “ketosterone” content advertised on labels was not linked to any effect in rats (see the callout above).
Side effects and risks
Reported side effects
Across trials, Cissus has been well tolerated over short periods:
- The 2017 meta-analysis found no serious adverse effects reported (Sawangjit et al., 2017).
- In the 24-week osteopenia trial, adverse event rates did not differ from placebo (Benjawan et al., 2022).
- In the hemorrhoid trial, no adverse events or blood chemistry changes were reported (Panpimanmas et al., 2010).
The Thai weight trial listed side effects in detail. With 15 people per group, these counts are too small to show a real difference (Chatree et al., 2021):
| Side effect | Cissus 600 mg/day (n = 15) | Placebo (n = 15) |
|---|---|---|
| Warm sensation | 4 | 1 |
| Dry mouth | 3 | 2 |
| Constipation | 3 | 1 |
| Nausea | 1 | 1 |
| Dizziness | 1 | 1 |
| Headache, stomach gas, mouth ulcer, diarrhea | 1 each | 0 |
Liver and kidney function tests did not change over 8 weeks in that trial.
Gaps in the safety data
- Duration: the longest controlled trial lasted 24 weeks, so long-term safety is unknown.
- Pregnancy and breastfeeding: pregnant and breastfeeding women were excluded from trials, for example in Oben et al., 2006, so there are no safety data.
- Interactions: no drug-interaction studies have been published. Several weight trials reported lower fasting glucose and lipids, so effects alongside diabetes or lipid drugs have not been studied.
- Animal toxicity: reviews report an oral LD50 (the dose lethal to half of test animals) above 3,000 mg/kg in animals (Bafna et al., 2021). This says little about long-term human use.
Product quality
Cissus products differ in plant part, extraction method and standardization marker. Labels in the NIH database claim “ketosteroid” contents from 2.5% to 60%, a marker that does not predict biological activity (NIH DSLD; Jadhav et al., 2016). The trial results above apply only to the specific products tested, and several of the weight-loss products were multi-ingredient formulas; one listed a high-caffeine green tea extract among its ingredients (Oben et al., 2007).
Key takeaways
- Traditional bone herb, thin clinical evidence. Small, mostly low-quality trials suggest faster fracture healing, but no large placebo-controlled fracture trial exists.
- No effect on bone density so far. In a 24-week placebo-controlled trial in postmenopausal women, Cissus slowed bone turnover markers but did not change bone mineral density.
- Weight-loss results are mixed. Positive trials come mostly from one group using company-supplied extracts and combination products. An independent trial found no effect on weight or body fat.
- Not shown to be anabolic. No human trial has tested muscle or strength, and “ketosterone” standardization on labels has no demonstrated link to any effect.
- Short-term tolerability looks good. Trials up to 24 weeks report no serious adverse effects, but long-term, pregnancy and interaction data are missing.
Sources
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- Stohs SJ, Ray SD. A review and evaluation of the efficacy and safety of Cissus quadrangularis extracts. Phytother Res. 2013;27(8):1107–1114. PubMed.
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- National Institutes of Health, Office of Dietary Supplements. Dietary Supplement Label Database (DSLD), search for “cissus.” NIH DSLD.
- Dadge SD, Syed AA, Husain A, et al. Simultaneous estimation of quercetin and trans-resveratrol in Cissus quadrangularis extract in rat serum using validated LC-MS/MS method: application to pharmacokinetic and stability studies. Molecules. 2023;28(12):4656. PubMed.
- Guerra JM, Hanes MA, Rasa C, et al. Modulation of bone turnover by Cissus quadrangularis after ovariectomy in rats. J Bone Miner Metab. 2019;37(5):780–795. PubMed.
- 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. Sci Rep. 2021;11(1):2008. PubMed.
- US Food and Drug Administration. Dietary supplements. FDA.
- World Anti-Doping Agency. The 2026 Prohibited List. WADA 2026 Prohibited List.
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