Table of Contents
Cissus quadrangularis (Linn), a plant that belongs to the Vitaceae family  is a common medicinal plant that has long been found in Africa and Asia for over a century . In addition, stems and leaves extracts from Cissus has been used in food preparation and as a raw drug in India for the treatment of various diseases . Cissus goes by other names, such as Had-jod – which means “that heals fractured bones” or “bone healer”, in Bengali, and Edible Stemmed Vine, in English , . Table 1 gives a brief overview of stem and leaf uses from the plant. Cissus is often used as a bodybuilding supplement to aid joint pain.
Table 1. Brief summary of the treatment potential of Cissus quadrangularis from stem and leaf extracts. Cissus is used in the treatment of the many ailments listed in this table. Many of these treatments are based on the plants use in local cultures, such as Sri Lanka, India and South-East Asia.
|Stem and leaf|
|Burns and wounds|
|Decrease in blood-pressure: Water-soluble extract (might contribute to lowering in blood pressure).|
|Treatment of Osteroporosis|
|Some Bowel infections|
Figure 1: Two tetracyclic triterpenoid structures found in the Cissus quadrangularis stem. The benefits of these compounds lie in the functional abilities to treat several pathological states, such as cardiovascular complications, tumour and cell proliferation and inflammation . These structures could contribute to the many health benefits taken from Cissus stem and leaf extracts.
Benefits and Effects
Cissus stem and leaves have been used for the treatment of indigestion, dyspepsia, bone fractures, along with diarrhoea and haemorrhoids , , . In addition to these benefits, Cissus is involved with fracture healing, antibacterial and anti-hemorrhoidal activates . In the latter, Cissus powder has been reported to treat haemorrhoids along with some bowel infections . Gastric disorders have been treated through a rich source of carotenoids, triterpenoids and ascorbic acid from Cissus.
The stem derived from the Cissus plant has been described as a reputable source for the treatment of irregular menstruation and asthma, an analgesic in ear and eye diseases and relief in back pain . What’s more, this plant has been shown to exert weight loss effects associated with metabolic disorders , . One study that sought to isolate extracts from Cissus, found nine compounds which have been identified as having a positive effect . In addition to these, Cissus is known to contain steroids, stilbenes, flavonoids, lipids and triterpenoids  – Table 1.
Bone fractures and tendon restoration
Cissus has been previously reported to relieve pain in patients suffering from Osteoarthritis, in which Cissus was associated with producing prostaglandins – the molecule attributed to pain . This plant herb has been noted as showing beneficial effects on bone, with Cissus significantly improving the healing process in bone fractures .
One study reported Cissus as a plant agent possessing regenerative and anti-inflammatory properties – to elicit protection and regenerate articular cartilage (Figure 2). Inflammatory indicators, such as cytokines and matrix metalloproteinase were shown to be inhibited by Cissus which is known to alleviate bone and cartilage destruction . In other work seeking to define the effect of Cissus in osteoblasts, results confirmed that role in bone formation; results concluded that ethanol extracts of Cissus affected the growth profiles of these cells. In this regard, Cissus can influence bone formation with the ethanol extract having the potential to heal fractures and prevent osteoporosis – a disease associated with increasing the fracturing of fragile bones.
Cissus also has also been reported to protect and restore muscles and tendons , . The action of 3-ketosteroids, found in the plant herb, is anabolic and is able to pass on anti-glucocortoid properties to tissues [15 Although not entirely clear on whether Cissus, in powder or fresh form, reviews discussing the effect of Cissus on tendonitis is available through many online platforms.
Obesity and weight loss
Studies seeking to uncover the role of herbal medicines in the management of obesity have found that a 300mg dose of Cissus over 10 weeks, in combination with Irvingia gabonensis, showed a significant decrease in body weight and body fat loss percent. Another study using a 300mg dosage treatment of Cissus in overweight and obese individuals, showed significant decreases in serum lipids and glucose along with significant increases in plasma serotonin and creatine levels .
In a randomised double-blind designed experiment which recruited 123 overweight and obese people, Cissus was formulated with other natural plant compounds. In this study, the plant formulation showed efficacy in managing weight loss and metabolic syndrome. This positive change – through a reduction in weight, % body fat, BMI, and waist circumference of obese and overweight individuals – was due to a twice-daily dose of 514mg for 8 weeks . Another study evaluating the effects of Cissus –administered in capsules – on weight loss in 72 obese or overweight people, found considerable waist size reduction after 10 weeks. Also, when combined with Irvingia gabonensis, a synergistic effect was reported; decrease of total cholesterol, LDL-cholesterol, and fasting blood glucose (when compared to Cissus quadrangularis) .
Bacteria and fungi
Leaf extracts of Cissus quadrangularis has been reported as possessing inhibitory activity against several fungal pathogens , . These fungal pathogens have been described as C. albicans, C. neoformans and Aspergillus species . In addition to leaf extracts, stem extracts of Cissus quadrangularis have also been reported to possess anti-fungal properties .
Table 1. Summary of some anti-microbial and anti-fungal activities of Cissus extracts. (List not exhaustive).
|Bacillus subtilis||Candida albicans|
|Bacilus cereus||Candida parapsilosis|
|Staphylococcus aureus||Cryptococcus neoformans|
|Pseudomonas aeruginosa||Aspergillus brasiliensis|
Data taken from  and .
What is Cissus extract? What this refers to, is the process where stem and leaf samples from the Cissus plant (dry and fresh) are processed, usually in a chemically-based assay, where each processed sample is then transferred to a vial containing a known substance – ethanol, methanol, water, chloroform, benzne and petroleum ether. These Cissus extracts are then used to study their effects or impacts – both negative and positive – in vitro (cells) and in vivo (body) experiments. An example of an extract with therapeutic effects is an ethanol extract of Cissus. In this example, an ethanol extract was shown to induce anabolic and osteogenic properties . Laboratory results have indicated the various phytochemicals contained in fresh stem and dry stem extracts from the Cissus plant (Table 1 and 2).
Table 1. Phytochemical profile of different Cissus extracts taken from fresh stem.
|Phytochemical||Fresh stem extracts|
Table 2. Phytochemical profile of different Cissus extracts taken from dry stem
|Phytochemical||Fresh stem extracts|
Cissus contain many beneficial extracts that have been said to possess pharmacological action . with stem, leaf and root extracts having properties considered crucial in managing various ailments . Alcoholic extracts have been shown to assist in the healing process of fractured bones in rats  Reports assessing the action of the ethanol extract of Cissus Linn in a diabetes-mediated hyperglycaemic bone cell model system, showed that the ethanol extract of Cissus was able to influence osteoblast cell growth (Figure 2). A dried methanol extract from Cissus powdered stems was shown to initiate faster bone healing in dogs. In this study, a 50mg/kg dose impacted bone healing in 21 days of extract administration . Antioxidant and antimicrobial activity has also been shown from the extracts of Cissus . Dry and fresh stem extracts, in a dose-dependent manner, were reported as showing antioxidant activity (Figure 3).
Figure 2. Dose-dependent Cissus extract was able to have anabolic effects on osteoblasts. This extract was able to increase cell life (Y-axis), against a background of high glucose.
Graph taken from .
Figure 3. Alcoholic and water extracts of Cissus. Left: Observed is the increase in antioxidant activity with an increase in fresh stem extract concentration. Right: Dry stem extracts and their antioxidant effects.
Cissus verticillata is a medicinal plant that is commonly found in and known in Brazil as “cipo-puca”, “aniltrepador” and “cortina”  and also as “plant-insulin”  It is also found in places such as the Caribbean islands of Trinidad and Tobago  Cissus verticillata is also known to treat hypertension, tremors, is an activator of blood circulation and an anticonvulsant .
Remarkably, the leaves of this plant have been previously used as a remedy for diabetes ; possessing anti-diabetic and anti-cholesterol activity . In an animal study, the antioxidant activity of a methanol extract from Cissus verticillata was reported as possibly having a role in the antidiabetic effect that has previously been reported from this plant . Cissus, from an alcohol extract, has also been shown to have anti-diabetic activity . This was concluded through a significant reduction in blood glucose levels, and was likely a result from the phytochemicals within the alcohol extract. In studies uncovering the role of Cissus in in osteopenia type I diabetes, rats were shown to have improved histological, biomechanical and biochemical effects in bone. These changes were attributed to the possible antioxidant and anti-inflammatory properties of Cissus .
Super Cissus, which is from Cissus, has many of the health benefits from the plant, such as pain relief and tendon repair properties . Super Cissus is said to contain only 800mg of Cissus, along with amounts of gelatin and cellulose; although, there are no academically published data on any comparison or health reports on this formula. Other sites list Magnesium Stearate, Silicon Dioxide, Corn Starch and Titanium Dioxide, in capsule form. In this respect, more research should be carried out before considering this product.
In treating haemorrhoid patients, a dosage schedule of two, 500mg capsules, dry powder form, were recommended twice daily as an effective treatment for haemorrhoid pain and inflammation, along with haemorrhoid size reduction . However, this study is not conclusive, and data remains unclear for haemorrhoid improvement . In an 8-week study assessing the effects of Cissus (as Super Cissus) on joint pain, 3200mg was given to 29 adult men. In this study, the time-dependent dosage strategy was reported as reducing joint pain in the adult subjects .
A large clinical study of Cissus (Linn) reported that Cissus dosage varies depending on what is being treated – within the clinical setting being investigated . Significant reductions in swelling, pain and mobility at bone fracture sites from 2, 300mg capsules of powdered Cissus . Table 3 briefly summarises these dosages based on clinical setting.
Table 3. List of the documented dosages of Cissus on a several conditions. This list contains extracts, combinations and formulations of Cissus in treating these conditions.
|3g/day for 4 days; then 2g/day for 3 days2|
|Obesity and weight management||150mg capsule extract1|
250mg capsule combination of Cissus extract1
|300mg twice daily (Cissus extract)2|
|Bone fractures||4g drink with milk twice a day1|
10g per day divided over three doses1
|1Sawangjit et al., 2017|
2 Stohs et al., 2012
No reported side effects have been documented with Cissus. However, it should be noted that as clinical studies investigating the benefits of Cissus extracts and formulations are still being determined, there have been no studies demonstrating that Cissus has anabolic and body building activities . Safety in Cissus extracts has been reported as “exceedingly safe”  and there are filed patent applications for Cissus extracts .
Cissus has been stacked with PAGG (Policosanol [23g], Alpha Lipoic acid [100-300mg], Green tea extract [325mg] and Garlic extract [200mg] . Cissus can also be stacked with other joint health supplements, such as Glucosamine. In general health, Cissus can be stacked with multivitamins and minerals.
Cissus has both positive and negative reviews. User reviews of this product can be found on WebMD, where a total of 42 reviews can be viewed. 234 customer reviews can be found on Amazon, with an average 86% 5-star rating.