Asthishrinkhala: Benefits, Evidence, Dosage & Safety

TL;DR

My read on asthishrinkhala, the bone-setter: a 9-person fracture pilot and a 50-person open-label trial of a Cissus–Boswellia formula report faster healing, but all are small or uncontrolled. Weight-loss RCTs show modest metabolic effects over 8–10 weeks. Traditional bone claims rest on thin human data. Promising nickname, thin evidence.

What it is

The name is the pitch. Asthishrinkhala, also written asthisamharaka, literally means "that which joins bone." Hadjod in Hindi. The plant is Cissus quadrangularis Linn., a climbing plant in the grape family (Vitaceae), and the stem is the part used: it is listed in the Ayurvedic Pharmacopoeia of India (Part I, Vol. III) under the name Asthisamhrta (JETIR review). Traditionally the young shoots and leaves get used too (Ayurvedic Pharmacopoeia of India, Part I, Vol. III; IAMJ review).

An herb that named itself after its job. Whether it does the job is the rest of this article.

Traditional use

Classical texts describe it as madhura (sweet) in taste and post-digestive effect, ushna (heating) in potency, laghu–ruksha (light, dry) in quality, used in asthidhatukshaya (depletion of bone tissue, which classical commentators compare to modern osteoporosis) (JETIR review). A review of its classical profile notes use for fractures, piles, chronic ulcers, asthma, and digestive complaints, with formulations like Asthishrinkhala Vatak described in the texts (IAMJ review).

Traditional claims. Not clinical proof. The human evidence is next, assessed separately, and I will not let the two bleed together.

What modern research says

Fracture healing (small human studies)

Nine people. That is the entire human evidence base for the bone-setter reputation, plus a couple of slightly larger studies with their own problems. Let me walk through them honestly.

A pilot study of 9 patients with maxillofacial fractures: one group (n=5) got a 500 mg C. quadrangularis capsule three times daily for 6 weeks, the other (n=4) got no supplement. The treated group showed less pain, swelling, and fragment mobility, and earlier radiographic healing on day 21 (Brahmkshatriya et al., 2016). Nine patients. No blinding. This is very weak evidence.

A multicentric, randomized but open-label study of 50 adults with distal radius fractures compared standard treatment alone against standard treatment plus CL16019, a combination of C. quadrangularis and Boswellia serrata extracts, for 60 days. The combination group scored higher on the Radius Union Scoring System (7.96 vs 5.54, p<0.0001) and reported less pain and better wrist function (CL16019 trial, CTRI/2021/12/039006). Two herbs in one product, no blinding: the effect cannot be attributed to Cissus alone.

And a randomized prospective study of 30 tibia-fracture patients found no significant difference between the Cissus and control groups in pain, mobilization, calcium, or phosphorus. Only alkaline phosphatase differed significantly. The authors concluded a larger sample was needed before Cissus could join fracture regimens (IJSR, 2023).

So: one tiny positive pilot, one positive combination study that cannot isolate Cissus, one negative-ish randomized study. That is the state of the "bone-setter" evidence. I would not call it settled in either direction.

Weight and metabolic markers (randomized trials)

Odd detour, but here we are: the best-designed human trials of Cissus are not about bones at all. They are about weight.

An 8-week randomized, double-blind, placebo-controlled trial in 123 overweight and obese adults found that a C. quadrangularis formulation produced statistically significant net reductions in weight, central obesity, fasting blood glucose, total and LDL cholesterol, triglycerides, and C-reactive protein versus placebo, with or without diet (Nash et al., 2008). A separate 10-week randomized, double-blind, placebo-controlled trial in 72 overweight or obese adults found significant improvements versus placebo on body weight, body fat, waist size, total and LDL cholesterol, and fasting glucose, both for Cissus alone and for a Cissus–*Irvingia gabonensis* combination (Nash et al., 2008).

Small, short trials of proprietary formulations. The results need replication before any general weight-loss claim can stand. Interesting, though: the metabolic signal is arguably better evidenced than the fracture one.

Bone density (animal evidence only)

In ovariectomized rats, an animal model of postmenopausal bone loss, ethanol extract of C. quadrangularis showed anti-osteoporotic effects (Shirwaikar et al., J. Ethnopharmacology, 2003).

Preclinical evidence only. It does not establish that the herb prevents or treats osteoporosis in humans.

What the evidence does not support (yet)

No large, blinded, placebo-controlled trial has established that asthishrinkhala speeds fracture healing or treats osteoporosis in humans. The traditional "bone-setter" reputation rests on small, low-quality human studies and animal work. A great name is not data.

Dosage

No pharmacopoeial dose was identified for asthishrinkhala. What the studies used: one 500 mg capsule three times daily for 6 weeks (the maxillofacial-fracture pilot) (Brahmkshatriya et al., 2016). Two 500 mg capsules (frequency not specified in the published abstract) in an observational fracture study (IAJPR); 300 mg daily of the CQR-300 extract in a weight-loss trial (Nash et al., 2007).

Study protocols, not dosage recommendations. Any use should be guided by a qualified practitioner.

Safety & contraindications

A three-month subchronic toxicity study in Wistar rats found no toxicity from C. quadrangularis stem powder at doses up to 3 g/kg body weight per day, roughly 100 times the estimated human therapeutic dose (Attawish et al. 2002, cited in Kothari et al. 2011). A separate 90-day study of the CQR-300 extract set the no-observed-adverse-effect level at 2,500 mg/kg/day in rats and found no genotoxicity in Ames, chromosomal-aberration, or micronucleus assays (Kothari et al., Food Chem Toxicol 2011).

Reassuring in rats. Human safety data are limited to short trials of a few weeks. There are no safety data for pregnancy or breastfeeding, so talk to a clinician before use, especially if pregnant, breastfeeding, or taking medication for blood sugar or cholesterol.

FAQs

Does asthishrinkhala heal fractures faster?

Possibly, but the evidence is weak, and I want that word, weak, to carry its full weight. The best human data are a 9-person unblinded pilot and a 50-person open-label trial of a Cissus–Boswellia combination. Both reported faster healing. Neither was a blinded placebo-controlled trial of Cissus alone (Brahmkshatriya et al., 2016; CL16019 trial). And a 30-person randomized tibia-fracture study found almost no significant differences (IJSR, 2023).

Does it help osteoporosis?

Not proven in humans. Anti-osteoporotic effects have been reported only in ovariectomized rats, an animal model of postmenopausal bone loss (Shirwaikar et al., 2003). No human trial has tested asthishrinkhala for bone density or fracture prevention. The name promises; the data do not, yet.

Does asthishrinkhala help with weight loss?

Two small randomized, double-blind, placebo-controlled trials (123 and 72 participants, 8–10 weeks) reported significant reductions in weight, body fat, and metabolic markers versus placebo (Nash et al., 2008; Nash et al., 2008). Short trials, proprietary formulations. Preliminary, and it needs independent replication before anyone sells it as a weight-loss herb.

What doses were used in studies?

Study protocols include 500 mg three times daily for 6 weeks (fracture pilot), two 500 mg capsules (observational fracture study), and 300 mg daily of CQR-300 extract (weight-loss trial) (Brahmkshatriya et al., 2016; Nash et al., 2007). These are not dosage recommendations. A qualified practitioner should guide any use.

Is asthishrinkhala safe?

Animal toxicity data are reassuring: three months of high-dose stem powder caused no toxicity in rats, and a 90-day extract study found no genotoxicity (Kothari et al., Food Chem Toxicol 2011). But human data are limited to short trials, and there are no data for pregnancy or breastfeeding. Talk to a clinician first.

Can I take it while pregnant or breastfeeding?

There are no human safety data for pregnancy or breastfeeding, and no source was found establishing safety in these groups. Avoid use unless a qualified practitioner advises otherwise. That is the whole answer. It is a short one because the data are absent, not because I am being terse.

Sources

The pharmacopoeial identity is the Ayurvedic Pharmacopoeia of India, Part I, Vol. III, which lists Asthisamhrta as the stem of Cissus quadrangularis Linn. (no online text cited). The classical profile draws on two reviews: Aswany K.R. et al., "A critical analysis on osteogenic activity of Cissus quadrangularis (Asthisrinkhala)," IAMJ 2020 (full text), and a JETIR 2024 review of Asthishrinkhala in Asthidhatukshaya (PDF).

Fracture studies: the 9-patient maxillofacial pilot by Brahmkshatriya et al., Ayu 2016 (PubMed 27011718); the 50-patient CL16019 distal-radius trial, CTRI/2021/12/039006 (PubMed 41896193); Chaurasia et al.'s 30-patient tibia-fracture prospective study, IJSR 2023 (PDF); and an IAJPR observational fracture-healing study (PDF). Bone-density animal evidence is Shirwaikar A, Khan S, Malini S, "Antiosteoporotic effect of ethanol extract of Cissus quadrangularis Linn. on ovariectomized rat," J. Ethnopharmacology 2003 (PubMed 14611887).

Weight-loss trials, all Nash et al.: the 123-participant C. quadrangularis formulation trial, Lipids in Health and Disease 2008 (PMC1570348); the 72-participant Cissus/*Irvingia gabonensis* combination trial, same journal 2008 (PMC2330043); and the CQR-300 dosing paper, 2007 (PubMed 17274828).

Safety: a 90-day subchronic toxicity and mutagenicity assessment of the CQR-300 extract (Kothari et al., Food Chem Toxicol 2011 — NOAEL 2,500 mg/kg/day; no genotoxicity in Ames, chromosomal-aberration, or micronucleus assays), DOI 10.1016/j.fct.2011.09.029, and the 3-month stem-powder study cited therein (Attawish et al. 2002, no toxicity at up to 3 g/kg/day in Wistar rats).

Disclaimer

This article is for educational purposes only and is not medical advice. Herbal products can interact with medications and are not suitable for everyone. Talk to a qualified healthcare practitioner before use — especially if you are pregnant, breastfeeding, managing a medical condition, or taking prescription medicines.