# Asthishrinkhala

> Asthishrinkhala (Cissus quadrangularis L.) is a plant used in Ayurveda, from the Vitaceae family. Not listed in WHO monographs on selected medicinal plants; recognized in Ayurvedic Pharmacopoeia of India as Asthishrinkhala/Hadjod; available as dietary supplement in US and European markets.

## Key facts

- **Botanical name:** Cissus quadrangularis L.
- **Family:** Vitaceae
- **Pharmacopoeia status:** Not listed in WHO monographs on selected medicinal plants; recognized in Ayurvedic Pharmacopoeia of India as Asthishrinkhala/Hadjod; available as dietary supplement in US and European markets

## Names and identification

| Language | Name |
|----------|------|
| English | Asthishrinkhala |
| Latin/Botanical | *Cissus quadrangularis L.* |

## Key Phytochemical Constituents

- Ascorbic acid (vitamin C - high content)
- Beta-[sitosterol](/glossary/compounds-q-t/#sitosterol)
- 3-Ketosteroids (anabolic [steroids](/glossary/compounds-q-t/#steroids))
- [Quercetin](/reference/quercetinquercetin/)
- [Kaempferol](/reference/kaempferol/)
- Quadrangularin-A (stilbene derivative)
- [Resveratrol](/glossary/compounds-q-t/#resveratrolresveratrol)
- Piceatannol
- [Friedelin](/glossary/compounds-d-g/#friedelin) (triterpenoid)
- Calcium (high content as calcium oxalate)
- Alpha-amyrin and beta-amyrin

## How does it work?

- Osteogenic mechanism through MAPK pathway-dependent upregulation of alkaline phosphatase in osteoblasts, enhanced collagen synthesis, and accelerated calcium deposition at fracture sites
- Anti-inflammatory and [analgesic](/reference/analgesic/) action mediated by [quercetin](/reference/quercetinquercetin/) and other [flavonoids](/reference/flavonoids/) inhibiting COX-2 and pro-inflammatory cytokine cascades, reducing fracture-site inflammation
- [Antioxidant](/reference/antioxidant/) mechanism through [resveratrol](/glossary/compounds-q-t/#resveratrolresveratrol), piceatannol, and quadrangularin-A scavenging of reactive oxygen species, protecting osteoblasts from oxidative damage

## Which traditional uses are supported by research?

- Bone fracture healing acceleration validated through human clinical trials and meta-analysis showing significant improvement in bone biomarkers, confirming premier Ayurvedic use as Asthi Sandhanaka (bone setter)
- Anti-obesity and metabolic benefits validated through clinical studies showing weight and body fat reduction with CQR-300 extract supplementation
- Analgesic and anti-inflammatory properties validated through in vivo studies, confirming traditional use in pain management and musculoskeletal conditions

## What do recent clinical trials show?

- Na Takuathung M, Aisara J, Sawong S and others 2025. [The effects of Cissus quadrangularis on bone-related biomarkers in humans: a systematic review and meta-analysis](https://pubmed.ncbi.nlm.nih.gov/40707943/). *BMC complementary medicine and therapies*. PMID [40707943](https://pubmed.ncbi.nlm.nih.gov/40707943/) · [doi:10.1186/s12906-025-04995-8](https://doi.org/10.1186/s12906-025-04995-8)  
  Meta-analysis of human studies confirmed that Cissus quadrangularis supplementation significantly improved bone-related biomarkers including alkaline phosphatase and calcium levels, promoting bone healing and density improvement.

*2 further claims previously listed here could not be traced to a published paper and have been removed. An absence here means we could not identify the source, not that no work exists.*

## Recent safety updates

- 90-day subchronic toxicity study showed no adverse effects at doses up to 2500 mg/kg/day; in vitro and in vivo mutagenicity studies revealed no mutagenic potential; considered exceedingly safe at commonly used supplemental doses
- Minor reported side effects include headache, intestinal gas, diarrhea, and dry mouth; should be used with caution in diabetic patients due to hypoglycemic potential and in those on anticoagulants due to potential interactions

## Dosage forms and preparation

**Dosage Forms:** Churna (stem powder), Capsule, Tablet, Swarasa (fresh stem juice), Sandhi [Bala](/herb/bala/) Taila (medicated oil — external), Lepa (bone-setting paste), Ghana Vati

**Standard Dosage:** 3-6g stem powder twice daily; 500mg-1g extract capsule twice daily; 10-20ml fresh stem juice; external paste/oil as needed

**Bioavailability:** Good oral bioavailability for ketosteroids (particularly anabolic steroids like ketosterone). 3,3'-di-O-methylquercetin is a potent bioavailable flavonoid. [Resveratrol](/glossary/compounds-q-t/#resveratrolresveratrol) and related [stilbenes](/glossary/compounds-q-t/#stilbenes) show moderate absorption (~20%). Calcium content in stems is bioavailable. Fresh stem juice has better bioavailability profile than dried preparations. Traditionally administered with milk (calcium + stem bioactives for synergistic bone healing).

**Optimal Timing:** With warm milk twice daily for fracture healing (continue for 6-8 weeks). Before meals for osteoporosis prevention. External paste application at fracture site.

**Standardized Extract:** Stem extract (10:1) standardized to minimum 3% 3,3'-di-O-methylquercetin and minimum 2.5% ketosterones. Calcium content minimum 4% (as eleite). Total flavonoid content minimum 5%.

**Shelf Life:** 2 days (fresh juice); 18 months (powder); 2 years (capsules/tablets); 3 years (medicated oil)

**Storage:** Fresh stems refrigerated, process within 48 hours. Dried powder in airtight containers below 25°C. Capsules with desiccant.

**Marker Compounds:** Ketosterone, 3,3'-di-O-methylquercetin, [Resveratrol](/glossary/compounds-q-t/#resveratrolresveratrol), Piceatannol, Pallidol, Quadrangularin A-C, Beta-sitosterol, Calcium oxalate, Ascorbic acid, Beta-carotene

### Extraction Methods

- Fresh stem juice expression (Swarasa)
- Hydroalcoholic extraction (70:30) for phytosteroid enrichment
- Petroleum ether extraction for ketosteroid fraction
- Aqueous decoction for mineral-rich extract
- [Sesame oil](/glossary/concepts-m-y/#tila-taila) infusion for Taila preparation

### Synergistic Combinations

- With [Laksha](/glossary/concepts-a-m/#laksha) (lac) for fracture healing (classical [Laksha](/glossary/concepts-a-m/#laksha) + Asthishrinkhala combination)
- With [Ashwagandha](/herb/ashwagandha/) for bone density and strength
- With [Arjuna](/herb/arjuna/) for calcium metabolism
- With [Guduchi](/herb/guduchi/) for anti-inflammatory support in fractures
- With [Shatavari](/herb/shatavari/) and milk for comprehensive bone nourishment

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Canonical version of this page: https://nighantu.ageayurveda.com/herb/asthishrinkhala/

## Sources

- Amidha Ayurveda Herb Database (700+ herbs, CC-BY-4.0)
- Web research (clinical trials, WHO monographs, safety databases)
- Ayurvedic Pharmacopoeia of India

Published by Age Ayurveda in the Nighantu. Educational reference only, not medical advice.
Incorporates material from the Amidha Ayurveda Herb Database under CC BY 4.0.