Hadjod

The name Hadjod comes from the Hindi words had, meaning bone, and jod, meaning to join, which reflects the use for which the plant is best known. Sanskrit texts refer to it as Asthisamharaka and Asthishrinkhala, both conveying the sense of supporting the union of broken bones, while it is known as pirandai in Tamil and nalleru in Telugu. Hadjod is recorded in the Bhavaprakasha Nighantu under Guduchyadi Varga and in the Kaiyadeva Nighantu under Lakshmanadi Varga, where its principal action is described as Bhagna Sandhanakara, traditionally referring to supporting the healing of broken bones. The plant grows across India, Sri Lanka, Bangladesh, Africa and parts of Southeast Asia, and the succulent four-angled stem is the part most commonly used.

In Ayurvedic pharmacology, Hadjod is described as having Madhura Rasa (sweet taste). Its Guna are Laghu (light) and Ruksha (dry). It has Ushna Virya (heating potency) and Katu Vipaka (pungent post-digestive effect). Based on these properties, it is traditionally considered to pacify Vata and Kapha while potentially increasing Pitta. Traditional Karma include Bhagna Sandhanakara (supporting the healing of broken bones), Balya (promoting strength), Deepana (supporting appetite), Arshoghna (traditionally used for hae

Hadjod is known by a variety of names across India, many of which reflect its traditional use in supporting the healing of bone injuries.

• Botanical name: Cissus quadrangularis L.
• Family: Vitaceae
• Sanskrit: Asthisamharaka, Asthishrinkhala, Vajravalli, Asthisandhanaka
• English: veldt grape, adamant creeper, devil's backbone, bone setter
• Hindi: hadjod, also written harjora
• Tamil: pirandai
• Telugu: nalleru
• Malayalam: changalamparanda
• Kannada: mangaroli, also written sannalabeeru
• Marathi: kandvel
• Gujarati: hadsankal
• Bengali: harbhanga

The compounds below have been identified in the stem of Cissus quadrangularis and have been studied for their potential biological effects.

• Ketosteroids, which have been investigated for their potential role in supporting bone-forming cells
• Phytosterols, chiefly beta-sitosterol
• Triterpenoids, including taraxerol and friedelin
• Flavonoids, including quercetin and kaempferol
• Stilbenes, including resveratrol, piceatannol and quadrangularin A
• Carotenoids, chiefly beta-carotene
• Tannins and phenolic acids
• Ascorbic acid (vitamin C)
• Calcium oxalate, present in the stem as needle-shaped crystals called raphides, which can irritate the mouth and throat if the raw stem is eaten
• Minerals, with calcium present in the highest concentration, alongside phosphorus, magnesium, iron and zinc

The actions below describe the traditional uses and the effects that have been investigated in laboratory, animal and limited human studies.

• Osteogenic: may support the activity of bone-forming cells
• Anti-inflammatory: has been associated with lower levels of inflammatory markers
• Analgesic: is traditionally used to help relieve pain
• Antioxidant: may help neutralise free radicals
• Gastroprotective: is traditionally believed to help protect the stomach lining
• Antimicrobial: has shown activity against some bacteria and fungi in laboratory studies
• Antihyperglycaemic: may help lower blood glucose levels
• Phytoestrogenic: contains plant compounds that may have weak oestrogen-like activity

Most of this evidence comes from laboratory and animal studies. Human studies are limited, and findings, particularly for bone healing and bone density, have been mixed. Therefore, these properties should be regarded as potential effects rather than proven clinical benefits.

The points below describe how Hadjod is traditionally used and how it has been studied, together with the current strength of the evidence.

May Encourage the Cells That Rebuild Broken Bone

Ketosteroids and phytosterols in the stem have been shown in laboratory and animal studies to encourage osteoblasts, the cells that lay down new bone, and may support the mineralisation of the callus that bridges a fracture. This is why Hadjod is traditionally used alongside, and never as a replacement for, proper fracture reduction, immobilisation and medical care.

Traditionally Used to Support Bone Strength in Later Life

Laboratory studies suggest Hadjod may reduce the activity of osteoclasts, the cells that break down bone, while its antioxidant compounds may help reduce oxidative stress associated with bone loss. Human studies have produced mixed results, with one placebo-controlled trial showing changes in bone turnover markers but no improvement in bone mineral density.

The preclinical mechanism was shown in oestrogen-deficient mice (Azam et al., 2023). The human trial in postmenopausal women with osteopenia found no change in bone mineral density over 24 weeks (Benjawan et al., 2022), and a systematic review of human studies found no significant effect on bone biomarkers apart from parathyroid hormone (Na Takuathung et al., 2025).

Associated With Less Joint Pain and Swelling

Flavonoids and triterpenoids in the stem have shown anti-inflammatory activity in laboratory and animal studies and have been associated with lower levels of inflammatory chemical messengers. Based on its traditional use, Hadjod may help relieve mild joint pain and stiffness. Arthritis requires a doctor's diagnosis and appropriate treatment.

Believed to Protect the Lining of the Stomach

Animal studies suggest Hadjod extract may increase protective mucus in the stomach lining and reduce acid production, which may explain its traditional use for indigestion and stomach discomfort. However, there is limited evidence in humans to confirm these effects.

Supplies Antioxidant Compounds That Act on Bone Tissue

The stem contains ascorbic acid, carotenoids, tannins and phenolic compounds that have demonstrated antioxidant activity in laboratory studies. Because oxidative stress is associated with bone and cartilage breakdown, these antioxidant properties have been proposed as one possible explanation for the herb's traditional use in bone and joint care.

Note: Hadjod is a herbal medicine and is not intended to replace conventional medical treatment. A broken bone should always be assessed, treated and followed up by a doctor. Speak to a qualified Ayurvedic practitioner or your doctor before using Hadjod, especially if you take regular medication or have a long-term medical condition.

Hadjod is traditionally used in a small number of specific situations in Ayurvedic practice, and each one may involve a different form of the herb.

After a Bone Has Been Set and Immobilised

This is the classical use for which the plant is named. In traditional practice, the churna or juice is taken by mouth during the weeks while a cast or splint is in place, as supportive care alongside orthopaedic treatment rather than instead of it. The fracture itself should always be managed by a doctor.

In Long-Standing Joint and Back Complaints

Tablets and capsules are the usual forms, taken over weeks rather than days for stiffness and aching in the knees, hips and lower back. A qualified healthcare professional should review whether the herb is still appropriate rather than using it indefinitely.

For Everyday Aches After Physical Strain

Hadjod is traditionally used for muscle and joint soreness after heavy work or unfamiliar exercise. This is intended for short-term use. Pain that does not improve within a few days, or follows an injury, should be medically assessed.

As an External Paste Over a Painful Area

Lepa, a paste made from the powder or fresh stem, is applied over a stiff or aching joint and left in place for a set time before being washed off. It should be used only on intact skin. Do not apply it to open wounds, broken or inflamed skin, or over a suspected fracture.

As a Cooked Vegetable in South Indian Kitchens

In Tamil Nadu, the tender stem, known as pirandai, is peeled, chopped and cooked into thogayal or chutney. It is always cooked and often rubbed with sesame oil during handling because the raw stem contains calcium oxalate crystals that can irritate the skin, mouth and throat.

Hadjod is generally well tolerated by most adults, but some people should seek medical advice before using it, and others may need to avoid it altogether.

During Pregnancy

There is no reliable evidence on Hadjod during pregnancy, and the plant contains compounds that may act weakly at oestrogen receptors. Until more is known, Hadjod should be avoided during pregnancy unless both an obstetrician and a qualified Ayurvedic practitioner recommend its use.

While Breastfeeding

It is not known whether the active compounds in Hadjod pass into breast milk or what effects they might have on a breastfed infant. Consult with your doctor before taking it while breastfeeding, and stop using it and seek medical advice if your baby becomes unsettled, feeds poorly or develops a rash.

Kidney Stones or Chronic Kidney Disease

The stem contains calcium and calcium oxalate, and oxalate is a common component of some kidney stones. Anyone with a history of calcium oxalate kidney stones or chronic kidney disease should not use Hadjod without advice from their healthcare professional.

Before Planned Surgery

Because Hadjod may affect blood glucose and blood pressure, stop taking it at least two weeks before planned surgery and tell your surgeon and anaesthetist that you have been using it. Include it on the medicines list provided at your pre-operative assessment.

Hormone-Sensitive Condition

Hadjod contains plant compounds that may have weak oestrogen-like activity. People with a hormone-sensitive condition, or those taking hormone replacement therapy, tamoxifen or hormonal contraceptives, should seek specialist medical advice before using it.

In Children and Teenagers

There is no established dose of Hadjod for anyone under 18 years of age, and safety data in this age group are limited. It should not be given to children or adolescents except under the supervision of a qualified Ayurvedic practitioner and the child's doctor.

When Handling or Eating the Raw Stem

The fresh stem contains needle-shaped calcium oxalate crystals that can irritate the skin, mouth and throat. Applying a little sesame oil to your hands before peeling may reduce skin irritation. Never eat the stem raw; thorough cooking helps reduce this irritation.

Drinking Alcohol While Taking Hadjod

No specific interaction between Hadjod and alcohol has been studied. Excessive alcohol intake is known to impair bone health and slow fracture healing, so limiting alcohol consumption is advisable, particularly if you are taking Hadjod to support bone health.

Choosing a Product

Herbal products vary in strength and quality. Buy from a licensed Ayurvedic manufacturer, look for an AYUSH licence number on the pack, and check the batch number and expiry date. Avoid unlabelled loose powders or products that claim to cure diseases.

Note: These precautions are general guidance and are not intended to replace personalised medical advice. If you are pregnant, breastfeeding, taking regular medication or living with a long-term condition, speak to your doctor or a qualified Ayurvedic practitioner before starting Hadjod.

Hadjod is available in several forms, and each is used differently. General guidance is given below.

Taking Hadjod Churna (Powder)

• Measure 1.5-3 g (about half to one level teaspoon) per dose, twice daily.
• Mix with warm water, warm milk or a small amount of ghee until smooth.
• A teaspoon of honey may be added once the mixture has cooled slightly. Do not add honey to a hot drink.
• Take after food, morning and evening.
• Review its use with your practitioner after 8-12 weeks rather than continuing indefinitely.

Swallowing Hadjod Tablets and Capsules

• Follow the dose on the product label, as strengths vary. A common dose is one 500 mg tablet or capsule twice daily.
• Swallow whole with water after food. Do not crush tablets or open capsules unless directed on the label.
• Take the doses at the same times each day.
• Do not take both churna and tablets together unless advised by a qualified practitioner.

Drinking Fresh Hadjod Juice (Swarasa)

• The usual amount is 10-20 ml daily, taken as a single dose or divided into two doses.
• Dilute with an equal amount of water, as undiluted juice may irritate the mouth and throat.
• Take after food.
• Prepare fresh and use it on the same day.

Using Hadjod Ghrita (Medicated Ghee)

• The usual amount is one teaspoon once or twice daily.
• Take with warm water or mixed into warm milk after food.
• Anyone advised to limit saturated fat should consult their doctor before using this form.

Applying Hadjod Paste (Lepa) to the Skin

• Mix the powder with warm water or a carrier oil, such as sesame oil, to make a smooth paste.
• Perform a patch test on the inner forearm and wait 24 hours before use. Do not apply if redness, itching or burning develops.
• Apply a thin layer to the affected joint or muscle, leave for 20-30 minutes, then rinse with warm water.
• Use only on intact skin. Do not apply to open wounds, broken or inflamed skin, or over a suspected fracture.
• A suspected or confirmed fracture requires prompt medical assessment and appropriate immobilization.

Herbs Traditionally Used With Hadjod

Note: These combinations are based on traditional Ayurvedic practice and are not supported by strong clinical evidence in humans. Do not prepare herbal combinations on your own. A qualified Ayurvedic practitioner should decide which herbs are appropriate and in what proportions.

Dosage differs by age and dosage form, and the table below provides general guidance for each group.

Note: This dosage information is for general reference only and is not a substitute for professional medical advice. Always consult a qualified Ayurvedic practitioner before starting, changing or stopping Hadjod, particularly if you have an underlying condition, are pregnant, or are already on treatment.

Most people tolerate Hadjod well, but the following side effects may occur, particularly at higher doses or when taken with certain medicines.

Stomach Upset, Nausea and Loose Stools

This is the most commonly reported side effect and tends to occur at higher doses. Symptoms may include nausea, bloating, wind, stomach cramps or loose stools. Taking Hadjod after food and starting with a lower dose may help reduce these effects.

Low Blood Glucose

Hadjod may help lower blood glucose levels. If you take insulin or other glucose-lowering medicines, it may increase the risk of hypoglycaemia. Shakiness, sweating, hunger, confusion and a racing heartbeat are common warning signs. Treat low blood glucose as advised by your diabetes care team and inform them that you are taking Hadjod.

Lowered Blood Pressure

Hadjod may help lower blood pressure and may enhance the effects of blood pressure medicines. Dizziness, light-headedness on standing or unusual tiredness may occur. Stand up slowly and consult your doctor if these symptoms persist.

Headache

Headache may occur occasionally, particularly during the first few days of use. It is usually mild. If it is severe, persistent or associated with visual changes, stop taking Hadjod and seek medical advice.

Mouth and Throat Irritation From the Raw Stem

The fresh stem contains needle-shaped calcium oxalate crystals. Chewing or swallowing it raw can cause itching, burning and irritation of the mouth and throat, and handling it may irritate the skin. Thorough cooking helps reduce this irritation. Powders and capsules do not usually cause this problem.

Higher Oxalate Load in People Prone to Kidney Stones

The plant contains calcium oxalate, so it may not be suitable for people with a history of calcium oxalate kidney stones. Drink plenty of water and seek medical advice before using Hadjod.

Allergic Reactions

Allergic reactions to Hadjod are uncommon. Symptoms may include itching, rash, or swelling of the lips, face or tongue. Stop taking it at the first sign of an allergic reaction and seek medical advice.

Note: Stop taking Hadjod and seek urgent medical help if you develop swelling of the face, lips or tongue, difficulty breathing, a widespread rash, or low blood glucose that does not improve with appropriate treatment. Tell the healthcare professional that you have been taking Hadjod.

The interactions below are based mainly on laboratory studies, traditional use and the herb's known effects, rather than being confirmed in clinical studies. Tell your doctor and pharmacist if you are taking Hadjod, especially if you use regular prescription medicines.

Medicines for Diabetes

Hadjod may help lower blood glucose levels. When taken with insulin, sulfonylureas, metformin or other glucose-lowering medicines, it may increase the risk of hypoglycaemia. Check your blood glucose more frequently when starting Hadjod, and inform your diabetes care team before using it.

Medicines for Blood Pressure

Hadjod may help lower blood pressure and may enhance the effects of antihypertensive medicines. Dizziness or light-headedness on standing may be an early sign. Have your blood pressure monitored and do not adjust your prescribed medicines without medical advice.

Cholesterol-Lowering Medicines

Limited evidence suggests Hadjod may help lower blood lipid levels. It may have an additive effect with statins or other lipid-lowering medicines, although clinically significant interactions have not been established. Tell your doctor if you are taking both.

Hormone Therapy and Hormonal Contraceptives

The plant contains compounds that may have weak oestrogen activity. Whether this is enough to affect hormone replacement therapy, tamoxifen or hormonal contraceptives is unknown. Anyone taking these medicines, or living with a hormone-sensitive condition, should seek specialist medical advice before using Hadjod.

Calcium and Vitamin D Supplements

Hadjod contains calcium and calcium oxalate. Taking it alongside calcium supplements may increase total calcium intake, which may be relevant for people with a history of calcium oxalate kidney stones. Discuss your supplement use with your doctor so your overall calcium intake can be assessed.

Medicines Around Planned Surgery

Because Hadjod may affect blood glucose and blood pressure, it may complicate their management during and after surgery. Stop taking it at least 2 weeks before planned surgery and include it on the medicines and supplements list provided at your pre-operative assessment.

Note: This is general information and is not intended to replace personalised medical advice. Speak to your doctor or pharmacist before using Hadjod with any prescribed medicine, and never stop or change your medication without medical advice.

Storage of Hadjod

Storage requirements vary depending on the form of Hadjod, and the fresh stem and fresh juice require more care than the powder.

• Keep churna, tablets and capsules in a tightly closed container in a cool, dry place away from direct sunlight, heat and moisture.
• Never use a wet spoon to handle the powder, as moisture can cause clumping and promote mould growth.
• Follow the expiry date on the pack. Once opened, churna is generally best used within 6–12 months, even if the printed expiry date is later.
• Store medicated ghee in a clean, dry, airtight container. Refrigerate during hot weather, and always use a dry spoon.
• Fresh juice should be prepared and consumed on the same day.
• Store fresh stems wrapped in the refrigerator and use them within a few days.
• Discard the product if it develops an unusual colour, a musty or sour smell, hard clumps, or signs of insect infestation.
• Keep all forms of Hadjod out of the sight and reach of children.

• Hadjod is the Ayurvedic name for Cissus quadrangularis, a climbing herb in the grape family. The four-angled stem is the part most commonly used.
• In Ayurveda, its classical action is bhagna sandhanakara, traditionally associated with supporting the healing of broken bones. It is described as madhura in rasa, ushna in virya, and katu in vipaka.
• Laboratory and animal studies suggest it may support bone-forming cells and have anti-inflammatory effects, but evidence in humans remains limited.
• Hadjod should never replace appropriate medical treatment for a fracture. It is traditionally used alongside fracture reduction, immobilisation and follow-up care.
• It may help lower blood glucose and blood pressure and may enhance the effects of medicines that do the same.
• Avoid Hadjod during pregnancy. Seek medical advice before using it if you are breastfeeding, have kidney stones or kidney disease, have a hormone-sensitive condition, or are planning surgery.
• There is no established dose for people under 18 years of age, so it should not be given to children or adolescents without supervision from a qualified Ayurvedic practitioner and their doctor.
• Tell your doctor and pharmacist if you are taking Hadjod, especially before surgery, starting a new medicine, or having treatment for a long-term condition.