Hadjod

Cissus quadrangularis
Hadjod (Cissus quadrangularis) is a prevalent herb in Ayurveda, known for its supposed effects on Vata, Pitta, and Kapha doshas. Traditionally, it's claimed to aid in bone health, often found in tropical regions. This "Bone Setter" or "Pirandai" has a long history of traditional use.
PLANT FAMILY
Vitaceae (Grape)
PARTS USED
Stem, Root, Leaves
AYURVEDIC ACTION
Vata ↓, Pitta ↓, Kapha ↓
ACTIVE COMPOUNDS
Ketosteroids (0.1-0.2%)

What is Hadjod?

Hadjod, scientifically known as Cissus quadrangularis, is a perennial plant belonging to the Vitaceae (Grape) family, widely recognized for its distinctive quadrangular stems. Native to tropical regions of Asia and Africa, it is a climbing vine that thrives in diverse environments. The plant is characterized by its succulent, jointed stems, which often appear almost leafless, and small, inconspicuous flowers that develop into reddish berries.

Historically, Hadjod has been utilized across various traditional medicine systems, particularly in Ayurveda, where it's valued for its unique properties. Its ability to grow in challenging conditions and its distinctive morphological features make it a notable species within its botanical family.

Other Names of Hadjod

  • Devil's Backbone
  • Veldt Grape
  • Adamant Creeper
  • Bone Setter
  • Pirandai

Benefits of Hadjod

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<h3> Absolute Contraindications of Cissus quadrangularis (Hadjod) </h3> <h4>Pregnancy (using simple terms: pregnant people)</h4> <ul> <li>🤰 <li>Recommendation: Avoid using Hadjod during pregnancy unless a qualified physician advises otherwise. <li>Reasoning: Animal studies show Cissus extracts can change fetal bone development and maternal hormone levels; effects during human pregnancy aren’t well studied, so use is not considered safe by default. <li>Scientific_Study_Title: Petroleum ether extract of Cissus quadrangularis (LINN) stimulates the growth of fetal bone during intra uterine developmental period: a morphometric analysis. <li>Scientific_Study_Authors: C. N. B. Chandrasekaran, P. R. M. S. (authors as listed on PubMed page). <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/19061006/ <li>Scientific_Study_Excerpt: <p>The referenced animal study reports that maternal administration of a petroleum-ether extract of Cissus quadrangularis to pregnant rats increased the ossified lengths of several fetal long bones (humerus, radius, ulna, femur, tibia) compared with controls, indicating stimulation of fetal bone ossification. The authors interpreted these morphometric changes as evidence that maternal CQ exposure modifies fetal bone growth during intra-uterine development; human safety data are lacking, so this raises concern about routine use in pregnancy and motivates avoidance until human safety is established.</p> </ul> <h4>Known or suspected estrogen-dependent (hormone-sensitive) cancers [e.g., certain breast or endometrial cancers]</h4> <ul> <li>⚠️ <li>Recommendation: Avoid Hadjod if you have or have had an estrogen-sensitive cancer unless advised by an oncologist. <li>Reasoning: Certain preparations of Cissus contain phytoestrogenic fractions and can raise estrogen markers in animal models; this theoretical estrogenic activity could affect hormone-sensitive tumours. <li>Scientific_Study_Title: Antiosteoporotic activity of phytoestrogen-rich fraction separated from ethanol extract of aerial parts of Cissus quadrangularis in ovariectomized rats. <li>Scientific_Study_Authors: S. Shirwaikar, S. Khan, S. Malini (as listed on PubMed). <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/22701244/ <li>Scientific_Study_Excerpt: <p>This preclinical study isolated a phytoestrogen-rich fraction from Cissus quadrangularis and demonstrated estrogen-like activity in ovariectomized rats: increased serum estradiol, vitamin D3 and calcium, and prevention of bone loss comparable to estrogen treatment in that model. Because the fraction influenced estrogenic markers and outcomes, the authors concluded the antiosteoporotic effect is mediated in part via estrogenic mechanisms. By extension, products with phytoestrogenic activity are approached cautiously in people with estrogen-dependent neoplasms.</p> </ul> <h4>Severe liver disease (significant hepatic impairment)</h4> <ul> <li>🛑 <li>Recommendation: Do not use Hadjod if you have severe, active liver disease unless supervised by a hepatology specialist; speak to your doctor first. <li>Reasoning: While many clinical trials report good tolerability, cellular and preclinical analyses have raised questions about effects on liver cells and metabolism; caution is prudent in existing serious hepatic impairment because metabolism and clearance may be altered. <li>Scientific_Study_Title: Evaluation of mutagenic, cytotoxic, mitochondrial dysfunction, apoptotic activity, and acute toxicity of ethanolic extract of Cissus quadrangularis. <li>Scientific_Study_Authors: (Authors listed on PubMed entry for PMID 36370889). <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/36370889/ <li>Scientific_Study_Excerpt: <p>This investigational study examined ethanolic extracts of Cissus quadrangularis in HepG2 hepatic cell models and in acute toxicity tests. The in vitro assays showed dose-dependent effects on some cell viability measures, prompting detailed evaluation of cytotoxic and mitochondrial markers; however, the acute toxicity arm in rats did not reveal frank acute hepatic toxicity at the tested dose. The mixed in vitro findings indicate a potential for liver-cell effects under some conditions and justify caution in people with compromised hepatic function pending more robust human safety data.</p> </ul> <h3> Relative Contraindications of Cissus quadrangularis (Hadjod) </h3> <h4>Diabetes or use of blood-glucose lowering medicines</h4> <ul> <li>🩺 <li>Recommendation: If you have diabetes or take insulin/sulfonylureas, consult your clinician before using Hadjod and monitor blood glucose frequently. <li>Reasoning: Animal and some human studies show Cissus preparations can lower fasting glucose and improve insulin sensitivity; combined with glucose-lowering drugs this could increase hypoglycaemia risk. <li>Scientific_Study_Title: Cissus quadrangularis extract attenuates hyperglycaemia-mediated oxidative stress in streptozotocin-induced diabetic rats. <li>Scientific_Study_Authors: (Authors listed on PubMed entry for PMID 24946070). <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/24946070/ <li>Scientific_Study_Excerpt: <p>In streptozotocin-induced diabetic rats, an ethyl-acetate fraction of Cissus quadrangularis improved glycaemic control, antioxidant status, and markers of liver function. Significant reductions in fasting blood glucose and improvements in insulin sensitivity were observed at effective doses, supporting a glucose-lowering biological effect in animal models; similar glucose reductions have been reported in human formulations. This supports caution when combining with anti-diabetic medications.</p> </ul> <h4>Planned surgery (perioperative period)</h4> <ul> <li>✂️ <li>Recommendation: Stop Hadjod at least 1-2 weeks before planned surgery unless your surgeon tells you otherwise. <li>Reasoning: Herbal agents that affect blood sugar, coagulation, inflammation or metabolism may change perioperative risk; because Cissus can lower blood glucose and influence metabolic markers, clinicians often advise holding it before surgery. <li>Scientific_Study_Title: The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome. <li>Scientific_Study_Authors: Oben et al. <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/16948861/ <li>Scientific_Study_Excerpt: <p>Clinical trials of Cissus formulations used for metabolic syndrome and weight loss reported significant reductions in fasting glucose and metabolic markers over weeks of use. Given these metabolic effects, perioperative guidance commonly recommends pausing supplements that alter glucose or haemostasis to reduce operative risk. While the study was not surgical, its metabolic findings underpin the perioperative caution.</p> </ul> <h4>Use with hormone replacement therapy or estrogenic drugs (relative caution)</h4> <ul> <li>⚖️ <li>Recommendation: If you are taking estrogen replacement or drugs sensitive to estrogen effects, discuss Hadjod with your prescribing clinician. <li>Reasoning: Cissus fractions with phytoestrogenic activity modulate estrogen markers in experimental models; additive or opposing effects with medical estrogen may occur. <li>Scientific_Study_Title: Antiosteoporotic activity of phytoestrogen-rich fraction separated from ethanol extract of aerial parts of Cissus quadrangularis in ovariectomized rats. <li>Scientific_Study_Authors: (Authors as on PubMed for PMID 22701244). <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/22701244/ <li>Scientific_Study_Excerpt: <p>The phytoestrogen-rich fraction increased serum estradiol and produced bone-protective effects similar to estrogen in ovariectomized rats, demonstrating biologic estrogenic activity in that model. This raises a theoretical interaction with estrogen therapy or estrogen-sensitive medications; clinical data on such interactions remain limited, so individualized medical advice is recommended.</p> </ul>

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<h4>Upset stomach, gas, diarrhea (digestive discomfort)</h4> <ul> <li>🤢 <li>Side effect summary: Some people report mild gastrointestinal symptoms - gas, bloating, loose stools - especially when starting the herb or taking higher doses/formulations. <li>Recommendation: If you get GI symptoms, stop the herb and speak with your healthcare provider; try lower dose or take with food if clinician agrees. <li>Reasoning: Clinical trials using Cissus formulations documented transient GI complaints as the commonest adverse events; these were generally mild and self-limited. <li>Severity Level: Mild <li>Scientific_Study_Available: Yes <li>Scientific_Study_Title: The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome. <li>Scientific_Study_Authors: Oben et al. <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/16948861/ <li>Scientific_Study_Excerpt: <p>In the randomized trial of a Cissus formulation for metabolic syndrome, adverse events with incidence above 5% included headache, gas, dry mouth, diarrhea and insomnia; these events were generally more common in the placebo group in that study and were considered mild. The trial authors concluded the formulation was well tolerated over the 8-week period with mainly mild, transient GI and related complaints reported.</p> </ul> <h4>Headache and insomnia</h4> <ul> <li>💤/🤕 <li>Side effect summary: Headache and difficulty sleeping have been reported in some clinical trials. <li>Recommendation: If you experience persistent headaches or sleep disturbance after starting Hadjod, stop and consult your clinician. <li>Reasoning: These non-specific adverse events were recorded in trials of Cissus formulations; causality is not always clear, but monitoring is reasonable. <li>Severity Level: Mild <li>Scientific_Study_Available: Yes <li>Scientific_Study_Title: The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome. <li>Scientific_Study_Authors: Oben et al. <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/16948861/ <li>Scientific_Study_Excerpt: <p>The study reported headache and insomnia among the more commonly observed events (headache n=12; insomnia n=6 across groups). Most events were transient and did not require study withdrawal, suggesting these are possible but generally mild effects in clinical populations receiving the formulation.</p> </ul> <h4>Potential for liver-cell effects (theoretical risk)</h4> <ul> <li>🧪 <li>Side effect summary: Some laboratory (cell-based) studies showed dose-dependent effects on liver cell viability and mitochondrial markers under experimental conditions; human evidence of hepatotoxicity is limited. <li>Recommendation: People with chronic liver disease should avoid or discuss with a liver specialist before taking Hadjod; stop and seek medical help for jaundice, dark urine, severe abdominal pain. <li>Reasoning: In vitro signals suggest liver cells can be affected at higher concentrations, though acute animal toxicity studies did not show frank liver failure at tested doses; human surveillance data are limited, so caution is warranted. <li>Severity Level: Moderate <li>Scientific_Study_Available: Yes <li>Scientific_Study_Title: Evaluation of mutagenic, cytotoxic, mitochondrial dysfunction, apoptotic activity, and acute toxicity of ethanolic extract of Cissus quadrangularis. <li>Scientific_Study_Authors: (Authors listed on PubMed entry for PMID 36370889). <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/36370889/ <li>Scientific_Study_Excerpt: <p>The in vitro assays in HepG2 cells demonstrated dose-related effects on several viability parameters that prompted further investigation of mitochondrial and apoptotic markers; however, the acute in vivo rat toxicity arm did not show significant liver enzyme elevation or acute hepatic damage at the doses tested. The mixed pattern warrants cautious interpretation and suggests monitoring in vulnerable individuals.</p> </ul>

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<h4>Blood-glucose lowering drugs (insulin, sulfonylureas, GLP-1 agonists, etc.)</h4> <ul> <li>Interaction_Details: Cissus preparations have been shown to reduce fasting glucose and improve insulin sensitivity in animal models and some human formulations; combining them with glucose-lowering drugs could increase the chance of low blood sugar. <li>Severity: Moderate <li>Recommendation: Consult your clinician before combining; if used, monitor blood glucose closely and be ready to adjust medication doses under medical supervision. <li>Scientific_Study_Available: Yes <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/24946070/ <li>Scientific_Study_Title: Cissus quadrangularis extract attenuates hyperglycaemia-mediated oxidative stress in streptozotocin-induced diabetic rats. <li>Scientfic_Study_Authors: (Authors listed on PubMed entry for PMID 24946070). <li>Scientific_Study_Excerpt: <p>In streptozotocin-induced diabetic rats, the Cissus quadrangularis fraction significantly reduced fasting blood glucose and oxidative markers, and improved insulin sensitivity and liver histology at effective doses. Clinical formulations have also shown reductions in fasting glucose in short human trials. These data support a glucose-lowering effect that could interact with prescribed antidiabetic medications, warranting monitoring.</p> </ul> <h4>Estrogenic agents and hormone therapy (HRT, selective estrogen modulators)</h4> <ul> <li>Interaction_Details: Cissus contains phytoestrogenic fractions that raised estrogen biomarkers in animal models; this could theoretically modify the effect of HRT or estrogen-modulating drugs. <li>Severity: Moderate <li>Recommendation: Discuss with your prescriber; avoid self-combination if you have hormone-sensitive conditions or are on estrogen therapy unless monitored. <li>Scientific_Study_Available: Yes <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/22701244/ <li>Scientific_Study_Title: Antiosteoporotic activity of phytoestrogen-rich fraction separated from ethanol extract of aerial parts of Cissus quadrangularis in ovariectomized rats. <li>Scientfic_Study_Authors: (Authors listed on PubMed entry for PMID 22701244). <li>Scientific_Study_Excerpt: <p>The phytoestrogen-rich fraction from Cissus quadrangularis increased serum estradiol and produced antiosteoporotic effects comparable to estrogen in ovariectomized rats. Given this estrogen-like activity in experimental models, combined use with exogenous estrogen or estrogen-modulating drugs could have additive or counterproductive effects; clinical interaction data are insufficient, so clinical oversight is advised.</p> </ul> <h4>Drugs metabolised by the liver (CYP substrates) - current evidence</h4> <ul> <li>Interaction_Details: Animal studies that examined hepatic CYP isoforms after Cissus administration generally did not find consistent, large changes in the CYP activities tested, but human interaction studies are scarce; unknown interactions remain possible. <li>Severity: Mild <li>Recommendation: For most people the interaction risk appears low based on limited animal data, but discuss with your clinician if you take critical-dose CYP-metabolised drugs (e.g., certain immunosuppressants, anticoagulants, anti-epileptics). <li>Scientific_Study_Available: Yes (animal data) <li>Scientific_Study_Link: https://li01.tci-thaijo.org/index.php/JBAP/article/view/36553 <li>Scientific_Study_Title: Effects of The Dried-Stem Powder of Cissus Quadrangularis on Hepatic Cytochrome P450, Clinical Blood Chemistry and Hematology in Rats. <li>Scientfic_Study_Authors: Khemchat Apipalakul, Supatra Srichairat, Laddawal Phivthog-ngam, Nuansri Niwattisaiwong, Somsong Lawanprasert (as listed in the abstract). <li>Scientific_Study_Excerpt: <p>In the reported rat study, oral dried-stem powder of Cissus quadrangularis given for 30 days did not produce significant changes in total hepatic microsomal CYP content or the activities of the tested CYP isoforms (CYP1A1, 1A2, 2B1/2B2, 2E1, 3A), nor did it significantly affect routine clinical biochemistry or hematology at the doses used. While this animal data suggests limited CYP modulation, human interaction studies are lacking and cannot be excluded.</p> </ul> <h4>Anticoagulants (warfarin, direct oral anticoagulants) - evidence status</h4> <ul> <li>Interaction_Details: No robust human or preclinical reports specifically document a direct interaction between Hadjod and common anticoagulants; theoretical concerns exist whenever herbal products alter liver metabolism or vitamin-K dependent pathways. <li>Severity: NA (insufficient evidence to categorise) <li>Recommendation: Because anticoagulants have narrow therapeutic windows, consult the prescribing clinician before starting any herbal product including Hadjod; monitor INR or anticoagulant effect if combination is used. <li>Scientific_Study_Available: NA <li>Scientific_Study_Link: NA <li>Scientific_Study_Title: NA <li>Scientfic_Study_Authors: NA <li>Scientific_Study_Excerpt: <p>There is insufficient PubMed evidence specifically showing an interaction between Cissus quadrangularis and anticoagulants at this time. Absence of evidence is not proof of absence; prudent clinical monitoring is advised if concurrent use is considered. </p> </ul>