Cissus Quadrangularis
Best-in-class: Cissus
An Ayurvedic herb traditionally used for bone healing, popular in lifting circles for joint and tendon complaints.
Cissus Quadrangularis quick facts
| Suggested dose | Commonly 500–3,200 mg daily of a standardized extract. |
| How often | Daily |
| Who it's for | Joint and tendon discomfort in lifters. |
Small trials in athletes show reduced joint pain, and the fracture-healing tradition is long. The glucocorticoid-antagonism mechanism is plausible and not well demonstrated in humans. It is also sold for appetite and body composition on much weaker grounds. Interesting, under-studied, low risk.
How Cissus Quadrangularis actually works
Traditional use for fracture and tendon healing. The proposed mechanism is glucocorticoid antagonism at the healing tissue — cortisol impairs collagen synthesis and bone formation, so blocking it locally would accelerate repair. Ketosterones and related compounds are the proposed actives.
Where to get Cissus Quadrangularis
Find Cissus Quadrangularis on iHerb →The evidence for Cissus Quadrangularis
Graded by what exists behind each claim.
✅ Clinically validated
- Small trials suggest reduced joint pain in exercising adults and some metabolic effects. Studies are small, largely regional and often industry-linked.
📊 Correlative data
- Long traditional use specifically for fracture healing.
🧪 Theoretical / extrapolated benefits
- Proposed osteogenic and anti-inflammatory activity; some glucocorticoid-antagonist activity is suggested, which would be interesting if confirmed.
How to read these tiers: they say how much human evidence exists, not how well something works — and ✗ flags harm, never a disappointing trial. How the evidence tiers work →
What Cissus Quadrangularis actually does
Cissus quadrangularis is a square-stemmed succulent vine in the grape family, used in Ayurvedic practice specifically for fractures — one of its Sanskrit names translates as “bone-setter”. That is an unusually precise traditional indication, and it is worth taking seriously enough to ask what molecule could possibly be doing it.
The honest answer is that nobody has identified one. The stem carries ketosterones — 3-keto steroids that most commercial extracts are standardized to, usually at 2.5% — along with quercetin and kaempferol glycosides, stilbenes, ascorbate, carotene, and a large amount of mineral matter including calcium as oxalate raphides. Reviews of the material describe this chemistry and the associated pharmacology without arriving at a single active constituent Stohs 2013. Every mechanism below is therefore a mechanism attributed to a mixture.
The osteogenic claim, stated at the level of the cell. The proposal is that the extract pushes mesenchymal cells toward the osteoblast lineage — the read-outs being alkaline phosphatase activity, RUNX2 expression and mineralized nodule formation in culture. In an ovariectomized rat model of postmenopausal bone loss, an ethanol extract of the stem produced an antiosteoporotic effect Shirwaikar 2003. That is a real animal result on a real model, and it is the strongest mechanistic evidence this plant has.
The glucocorticoid claim is the interesting one and it is unsupported. Cissus is widely marketed as a glucocorticoid antagonist — a claim that would matter enormously to a lifter, because it would mean blunting cortisol's catabolic action on tendon and bone. The plant's ketosterones share a steroid nucleus, which is where the idea comes from. What is missing is the experiment: no published binding assay at the glucocorticoid receptor, NR3C1, no reporter-gene antagonism data at a defined concentration, and no human cortisol measurement. Structural resemblance is a hypothesis, not a mechanism, and this page will not pretend otherwise.
What a tendon actually needs, for comparison. Tendon is type I collagen with a low cell density and a blood supply an order of magnitude poorer than muscle's; it remodels through tenocyte-driven collagen synthesis and cross-linking over months, and it responds measurably to mechanical loading. Any oral agent claiming to fix tendon pain has to either change that biology or change pain signaling, and the trials below cannot tell you which — because they measured pain.
Cell, rodent, human — and where it stops
The rodent step, which is the best-evidenced one. An ethanol extract of Cissus quadrangularis stem, given orally to ovariectomized rats, produced an antiosteoporotic effect Shirwaikar 2003. Ovariectomy in a rat is the standard model for estrogen-withdrawal bone loss, so the finding is on-target for the traditional indication.
The human step, with its real design and its real limitation. Twenty-nine men aged 20 to 46 took 3,200 mg of Cissus quadrangularis daily for eight weeks; mean total WOMAC score fell from 25.4 ± 2.4 to 17.4 ± 2.1, about 31%, pre- to post-intervention Bloomer 2013. There was no placebo arm: all 29 men received the extract, so the comparison is with their own starting score. Twenty-nine men, eight weeks, described by its own authors as a pilot study. That is the human evidence base for the joint claim in exercising adults, in full.
Now the arithmetic, because “3,200 mg” is a mass of plant rather than a dose of anything. At the usual 2.5% ketosterone standardization, 3,200 mg of extract carries about 80 mg of ketosterones — and that 80 mg is itself a mixture of related steroids, not one compound. Assume a molecular weight around 300 and complete absorption into 42 liters of body water, neither of which is true, and you get an upper bound near 6 micromolar for the whole class. Cell work on plant extracts is done at microgram-per-milliliter concentrations of crude extract applied directly to the cell. Those are not the same experiment, and nobody has measured the plasma concentration of any Cissus constituent in a human, which means the bound above is the best anyone can offer.
The obstacle, and it is specific to this product rather than generic. Two things confound the human result at once. First, the design: a pre-to-post change in 29 men is a measurement of a group that arrived at their worst and were measured again later, which is the shape regression to the mean takes. Second, the behavior: almost nobody starts a joint supplement without also backing off the movement that hurts, and the tendon's own response to load management runs on the same six-to-eight-week clock Bloomer 2013.
And the third obstacle, which is about who published. The review literature notes that the clinical trials of this plant are small and drawn from a narrow set of research groups Stohs 2013. That is not an accusation; it is a statement about how much independent replication exists, and the answer is very little.
Cissus Quadrangularis — which form, and does it matter
“Extract” here covers three different materials. Dried aerial stem powder, an ethanol extract of the stem, and a modern extract standardized to ketosterones are not interchangeable, and the two pieces of evidence on this page belong to different ones: the rat study used an ethanol extract Shirwaikar 2003 and the human pilot used a commercial preparation at 3,200 mg Bloomer 2013. A capsule labeled only Cissus quadrangularis could be any of the three.
The dose range on the card spans a factor of six, and only its top end has been tested. 500 mg and 3,200 mg are both printed as acceptable. The human joint result is at 3,200 mg Bloomer 2013. There is no human trial at 500 mg for anything on this page, so the bottom of the range is a serving suggestion rather than a dose.
Standardization is the only quality signal available. With no identified active, the ketosterone percentage is a proxy for extraction consistency rather than a measure of potency — but a proxy that is assayed batch to batch is worth more than a plant name. A label with no standardization statement gives you no way to tell this year's harvest from last year's.
Which plant part matters, and cheap products blur it. The traditional and studied material is the stem. Leaf and root are different chemistry and cheaper to collect. Genetic and chemical analyses of commercial Cissus material exist precisely because substitution within the genus is a known problem, and a powder cannot be identified by eye.
Take it with food, and know why. The stem is a mineral-dense succulent carrying calcium oxalate, and oxalate taken with a calcium-containing meal is bound in the gut rather than absorbed. That is mechanism-led rather than trial-led advice, and it costs nothing to follow.
What would have to be true, and how you would know it was not
1. Log the load, not just the pain. What to watch: pain during the specific lift that provokes it, written down next to the weight used and the number of sets, because pain that improves while the load falls is not an improvement. How long before it means anything: eight weeks at 3,200 mg, which is the tested protocol Bloomer 2013. What will fool you: deloading. Almost nobody starts a joint supplement without also backing off, and tendon complaints respond to load management on exactly the same clock.
2. Predict a WOMAC-scale change of roughly the pilot's size, or conclude against. The reported fall was about 31% on a total WOMAC score over eight weeks Bloomer 2013. Score yourself the same way at week 0 and week 8. A 5% wobble is noise; a third is the claim. This is one of the rare places where the published effect is large enough for an individual to detect, which makes the test worth running.
3. The prediction that cuts against the product. Predict hs-crp does not move at eight weeks. The plant is sold on a systemic anti-inflammatory mechanism, that mechanism has never been demonstrated to change a human inflammatory marker, and if a general anti-inflammatory effect were doing the work it should be visible in the cheapest inflammatory test there is.
4. Predict no measurable bone effect in eight weeks, whatever the rat data say. Bone remodeling runs on a months-long cycle and no DXA scan can resolve a change over a two-month course. If you want to test the osteogenic claim Shirwaikar 2003, the honest markers are turnover markers such as osteocalcin over three to six months, and even those tell you about activity rather than about strength.
5. And watch glucose if you have a reason to. Blood-glucose lowering is a reported effect of this plant Stohs 2013. In someone on insulin or a sulfonylurea, predict a downward drift in home readings within the first fortnight; in everyone else, predict nothing.
What nobody has tested yet
Nobody has run the glucocorticoid experiment. The most commercially important claim about this plant — that it antagonizes cortisol — needs one afternoon of work: a glucocorticoid receptor binding assay and a reporter-gene transactivation assay against dexamethasone, at stated concentrations. Nobody has published it, and the claim is repeated on every product page in the category.
Nobody has measured a human plasma concentration. No pharmacokinetic study of any Cissus constituent in a person exists, so there is no way to tell whether the concentrations that do things in a dish are ever reached. Until that number exists, every mechanistic claim on every label is unanchored.
Nobody has controlled for the deload. The obvious trial is two arms on an identical, prescribed, unchanged training program — extract against placebo — with load held constant by the protocol rather than by the participant. That removes the single largest confound in the existing human data Bloomer 2013 and it has never been done.
And nobody has tested the traditional indication. This plant is used for fracture healing, the rodent evidence is skeletal Shirwaikar 2003, and there is no randomized trial of radiographic union time after a distal radius fracture. That is a straightforward orthopedic study with a hard endpoint, and its absence after decades of traditional use is the most conspicuous gap here.
Cissus Quadrangularis — its own safety story, not its category's
The oxalate is this plant's own risk and almost nobody mentions it. Cissus quadrangularis stem is a mineral-dense succulent that stores calcium as oxalate crystals. Anyone who has passed a calcium-oxalate stone, has a history of hyperoxaluria, or has reduced kidney function is taking a daily oxalate load of unstated size for months, on a product with no oxalate specification on the label. This is reasoning from the plant's chemistry rather than from a reported case series, and it is stated because it is checkable, actionable and specific to this product rather than to its category.
The glucose effect is the interaction that is actually reported. Blood-glucose lowering appears in the review literature on this plant Stohs 2013, so on metformin, a sulfonylurea, a GLP-1 agonist or insulin it is additive rather than parallel. Home readings for the first two weeks answer the question at no cost.
The reported side effects are the ones that end courses. Headache, gastrointestinal upset, dry mouth and insomnia are the usual reports Stohs 2013, and they matter here for an unusual reason: quitting in week three of an eight-week protocol Bloomer 2013 leaves you with no result at all, having paid for the bottle.
The unstandardized-extract problem is a safety problem, not just a potency one. If the active is unidentified, so is the contaminant profile, and botanical substitution within the genus is a documented issue. A product with no species verification and no standardization is asking you to trust a supply chain you cannot inspect.
And the honest limit on everything above: weeks, not years, in under a hundred people. Eight weeks in 29 men Bloomer 2013 plus a review of small regional trials Stohs 2013 is the safety record. Pregnancy and breastfeeding are excluded from all of it, which is why nobody can answer that question, and the enthusiasm this plant enjoys in lifting communities is far out in front of the file.
Sources read for this page
- Bloomer RJ, et al. Cissus quadrangularis reduces joint pain in exercise-trained men: a pilot study. The Physician and Sportsmedicine, 2013 · PMID 24113700
- Stohs SJ, Ray SD. A review and evaluation of the efficacy and safety of Cissus quadrangularis extracts. Phytotherapy Research, 2013 · PMID 22976133
- Shirwaikar A, et al. Antiosteoporotic effect of ethanol extract of Cissus quadrangularis Linn. on ovariectomized rat. Journal of Ethnopharmacology, 2003 · PMID 14611887
How you would know if it worked
There is no blood test for this one. That is not a criticism — it is a fact about the effect, and it changes how you should judge it.
- What to watch: Tendon and joint pain during the specific lift that provokes it, logged against the load used. This is popular in lifting circles for that exact complaint, and the trials in exercising adults are small, largely regional and often industry-linked — so your own log is a fair share of the total evidence in existence.
- How long before it means anything: Six to eight weeks on a standardized extract. Tendon complaints respond to load management on a similar clock, which is precisely why the two get confused.
- What will fool you: Deloading. Almost nobody starts a joint supplement without also backing off the movement that hurts, and the rest of the credit goes to the capsule. Headache and GI upset are the reported side effects, and quitting mid-trial because of them leaves you with no result at all.
Run it one variable at a time. Starting three things in one week means a result you cannot attribute, which is the same as no result.
Cissus Quadrangularis — safety & side effects
- GI upset, headache, dry mouth and insomnia are the usual reports.
- Lowers blood glucose — additive with diabetes medication.
- Long-term safety has not been characterized — the trials run weeks to months, not years. That is a real limit on what anyone can tell you about daily use for a decade. The trial base is small and largely from a narrow set of research groups. Not established as safe in pregnancy or breastfeeding — not because harm is documented, but because these are the two populations systematically excluded from the trials. Absence of data is not reassurance.
Not medical advice. If you take prescription medication or have a diagnosed condition, check this against it with a pharmacist or doctor — pharmacists are underused and free.
- When to take it, and what to take it with
- Which form actually absorbs
- Who it's worth it for
- Best-in-class brand pick
- Coach Cam's stacks and notes
- Fasted or with food, and when in the day
- Morning or night, and why that window
- Around training, or deliberately away from it
- What it must not share a window with
Everything above is free and stays free. Skool is where it becomes a plan — Cissus Quadrangularis in an order, with the rest of what you're running.
Unlock in Skool — $10/mo →Bloodwork to run alongside Cissus Quadrangularis
Baseline first, then again at 8–12 weeks.
| Marker | What it’s watching for |
|---|---|
| Ferritin | Below 50 and hair and skin repair suffer, whatever else you take |
| Vitamin D (25-Hydroxy) | Skin, bone and connective tissue all depend on it |
| TSH (Thyroid-Stimulating Hormone) | Thyroid disease shows in hair, skin and nails first |
| Zinc, Plasma | Deficiency causes poor wound healing and hair shedding |
The Basics — Start Here panel covers these in one order — 4 markers, $32.40 with the discount applied.
Check results you already have → · All 103 markers A–Z
Cissus Quadrangularis — frequently asked questions
What is Cissus Quadrangularis?
An Ayurvedic herb traditionally used for bone healing, popular in lifting circles for joint and tendon complaints.
What is the suggested dose of Cissus Quadrangularis?
Commonly 500–3,200 mg daily of a standardized extract. This is a general reference for education only — statements have not been evaluated by the FDA and this is not medical advice.
Where can I find Cissus Quadrangularis dosing and the full breakdown?
The suggested dose and the full evidence — clinical, correlative and theoretical — are on this page. What's inside Skool is when to take it, which form actually absorbs, the brand worth buying and Coach Cam's stacks.
Where can I buy Cissus Quadrangularis?
Coach Cam sources Cissus Quadrangularis from vetted, top-rated brands on iHerb — use the buy link on this page.
What Cissus Quadrangularis is used for
Cissus Quadrangularis appears under 2 goals in the goal router.
Related Skin & Structural supplements
Where this goes next
The pages here are the frameworks. The protocols — the dosing, the order to correct things in, the week-by-week schedule and what to retest — are inside Skool.