Cissus Quadrangularis health benefit by Ray Sahelian, M.D.

March 25 2014

Cissus quadrangularis, a medicinal plant indigenous to Asia and Africa, is used for many ailments, especially for the treatment of hemorrhoids. It has a number of substances including iridoids such as picroside, stilbenes quadrangularin A, pallidol, quercitin, quercitrin, beta-sitosterol, and beta-sitosterol glycoside. See a list of botanical names.

Cissus quadrangularis and hemorrhoid pain
Analgesic, anti-inflammatory and venotonic effects of Cissus quadrangularis.
J Ethnopharmacol. 2006; Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
The effects associated with hemorrhoid, i.e. analgesic and anti-inflammatory activities as well as the venotonic effect of the methanol extract of Cassius quadrangularis were assessed in comparison with reference drugs. In the analgesic test, Cissius quadrangularis provoked a significant reduction of the number of writhes in acetic acid-induced writhing response in mice. Cissius quadrangularis also significantly reduced the licking time in both phases of the formalin test. The results suggest peripheral and central analgesic activity of Cissius quadrangularis. In acute phase of inflammation Cassius quadrangularis elicited the inhibitory effect on the edema formation of the rats' ear induced by ethyl phenylpropiolate as well as on the formation of the paw edema in rats induced by both carrageenin and arachidonic acid. It is likely that Cissius quadrangularis is a dual inhibitor of arachidonic acid metabolism. In addition, Cissius quadrangularis exerted venotonic effect on isolated human umbilical vein similarly to the mixture of bioflavonoids, i.e. 90% diosmin and 10% hesperidin. The results obtained confirmed the traditional use of cissius quadrangularis for the treatment of pain and inflammation associated with hemorrhoid as well as reducing the size of hemorrhoids.

Cissus quadrangularis and weight loss
The effect of Cissus quadrangularis (CQR-300) and a Cissus formulation (CORE) on obesity and obesity-induced oxidative stress.
Lipids Health Dis. 2007. Laboratory of Nutrition and Nutritional Biochemistry, Department of Biochemistry, University of Yaoundé I, Yaoundé, Cameroon.
The aim of this study was to compare the effect of a proprietary extract of Cissus quadrangularis (CQR-300) to that of a proprietary formulation containing CQR-300 (CORE) on weight, blood lipids, and oxidative stress in overweight and obese people. The first part of the study investigated the in vitro antioxidant properties of Cissus quadrangularis and CORE using 3 different methods, while the second part of the study was a double-blind placebo controlled design, involving initially 168 overweight and obese persons. All participants received two daily doses of Cissus quadrangularis, CORE, or placebo and were encouraged to maintain their normal levels of physical activity. Cissus quadrangularis (300 mg daily) and CORE (1028 mg daily) brought about significant reductions in weight and blood glucose levels, while decreasing serum lipids thus improving cardiovascular risk factors. The increase in plasma 5-HT and creatinine for both groups hypothesizes a mechanism of controlling appetite and promoting the increase of lean muscle mass by Cissus quadrangularis, thereby supporting the clinical data for weight loss and improving cardiovascular health.

The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome.
Lipids Health Dis. 2006. Department of Biochemistry, University of Yaounde I, Yaounde, Cameroon.
The purpose of the present study was to investigate the use of a Cissus quadrangularis formulation in the management of metabolic syndrome, particularly weight loss and central obesity. The study was a randomized, double-blind, placebo-controlled design involving 123 overweight and obese persons. The 92 obese (BMI >30) participants were randomized into three groups; placebo, formulation/no diet, and formulation / diet (2100-2200 calories/day). The 31 overweight participants (BMI = 25-29) formed a fourth (no diet) treatment group. All participants received two daily doses of the formulation or placebo and remained on a normal or calorie-controlled diet for 8 weeks. At the end of the trial period, statistically significant net reductions in weight and central obesity, as well as in fasting blood glucose, total cholesterol, LDL-cholesterol, triglycerides, and C-reactive protein were observed in participants who received the formulation, regardless of diet. Cissus quadrangularis formulation appears to be useful in the management of weight loss and metabolic syndrome.

No benefit was noted in this study. J Med Assoc Thai. 2010.  Experimental comparative study of the efficacy and side effects of Cissus quadrangularis to Daflon (Servier) and placebo in the treatment of acute hemorrhoids.

Cissus quadrangularis and ulcer
Gastroprotective action of Cissus quadrangularis extract against NSAID induced gastric ulcer: role of proinflammatory cytokines and oxidative damage.
Chem Biol Interact. 2006. Department of Biochemistry, University of Madras, A.C. Tech, Guindy Campus, Chennai, Tamil Nadu, India.
The objective of this research was to analyse the gastroprotective effect of Cissus quadrangularis extract along with its mechanism underlying the therapeutic action against the gastric mucosal damage induced by aspirin. In this study, we investigated the effect of Cissus quadrangularis extract on the course of experimentally induced gastric ulcer by analyzing the levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), microvascular permeability, activity of nitric oxide synthase-2 (NOS-2), mitochondrial antioxidants, lipid peroxidation and DNA damage. A significant increase in vascular permeability, NOS-2 activity, TNF-alpha, IL-1beta levels and oxidative damage were noted in aspirin administered rats. Pretreatment with Cissus quadrangularis extract (500 mg/kg bw/day) by oral gavage for 7 days significantly attenuated these biochemical changes caused by aspirin in rats. Tissue damage was showed by decreased levels of glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) and an associated rise in lipid peroxidation in mitochondria, which were reversed by Cissus quadrangularis extract . In addition, Cissus quadrangularis extract prevents oxidative damage of DNA by reducing DNA fragmentation indicating its block on cell death. Ulcer protection in Cissus quadrangularis extract treated rats was confirmed by histoarchitecture, which was comprised of reduced size of ulcer crater and restoration of mucosal epithelium. Thus, reduced neutrophil infiltration, antiapoptotic and antioxidant action have a pivotal role in the gastroprotective effect of Cissus quadrangularis extract.

Availability from raw herb and ingredient suppliers
Cissus quadrangularis extract comes in various potencies including 4% ketosteroids, 5% ketosteroids, a 5 to 1 extract and a 20 to 1 extract. 

Q. What can you tell me about Cissus (or veld grape herb)? I read recently that it significantly reduces body fat, especially around the waist and has “anabolic properties” which is wonderful if it’s true. I’m guessing that it’s similar to L-Carnitine in the sense that it’s more effective in obese individuals rather than those who are fit.
   A. I don't have any personal experience with cissus quadrangularis.

Q. I tried Cylaris to boost weight loss (have lost 35lbs so far without it). I read the ingredient list and took the recommended half dose. By the third pill I was violently ill with the worst headache I had ever experienced, photophobia, and nausea that progressed to vomiting. It turns out that I am allergic to Cissus Quadrangularis. After doing some research it makes sense, as I have “oral allergy syndrome”, or allergies to most trees / bushes and the proteins that are grown on them (for instance, the only raw vegetables or fruits that I can have are lettuce, cucumber, tomato, onion, and bananas. So much for big salads!). I am not advocating a warning label on any of the supplements, as it is up to the consumer to be aware of their own limitations, but if you ever encounter anyone with these types of allergies, please pass the information along.
   A. Cylaris is a combination of several vitamins, minerals, and natural herbs. According to one website, Cylaris Proprietary Weight Loss Blend has Caffeine Anhydrous, Cissus Quadrangularis Extract, Green Tea Extract, and Soy Albumin Extract. Whenever there is a formula with multiple substances in it, it is difficult to blame any particular ingredient unless each one is tried separately.

Q. I just wanted to ask if cissus quadrangularis has any blood clotting or blood thinning characteristics? This is if it is taken in a weight loss formula according to directions on the product label. I do not know the rest of the ingredients, but this is the main ingredient and I wanted to find out if it clots or thins a persons blood in any way, since the manufacturers never usually tell a person if it will or not on the supplement fact panel label.
   A. I have not seen human studies with this herb that has looked specifically at its blood clotting or thinning effects but since it contains flavonoids, it is more likely than not to have some blood thinning potential but I can't be sure.

I had been trying to research and find a supplement to help tighten overstretched sacral ligaments and read elsewhere on the web that this was a well known and effective use for this cissus quadrangularis. I noticed that you didn't mention that usage in your article at all. I just wondered if it's because it doesn't work well for that purpose or perhaps it wasn't mentioned for some other reason. Do you have any suggestions on how much is commonly taken and for how long to take it to tell if it's going to work or not? Lastly, would you have any concerns or caveats for an otherwise healthy person (who isn't on any prescriptions, only some other supplements) taking it?
   I have not seen studies regarding the use of this herb as a treatment for overstretched sacral ligaments.