Mwendo by Ambrosia Collective

POSSIBLY EFFECTIVE

• Obesity. Several small clinical studies suggest that oral Cissus quadrangularis extract, taken with or without other ingredients, can decrease body weight in those who are overweight or obese. Details: Two small clinical studies in adults with overweight or obesity shows that taking a specific Cissus quadrangularis extract standardized to 2.5% keto-steroids and 15% soluble plant fiber (CQR-300, Gateway Health Alliance) 300 mg daily for 6-8 weeks with a reduced calorie diet decreases body weight by around 4% to 11%, compared with a 0% to 3% reduction with reduced calorie dieting alone (15609,93637). Other small clinical studies in patients with overweight or obesity shows that taking 300 mg of this product daily for 8-10 weeks without following any specific diet decreases body weight by about 8% to 9%, compared with about 2% in those taking placebo (16457,99257). Taking this product also appears to reduce body fat by about 13%, compared with no decrease in those taking placebo (99257). However, most of these studies are of moderate to low quality, and all are short-term, limiting the reliability of the findings. Cissus quadrangularis has also been evaluated in combination with other ingredients. Several small clinical studies show that taking a specific combination product containing Cissus quadrangularis (standardized to 2.5% keto-steroids and 15% soluble plant fiber), green tea, soy, chromium, selenium, and B-vitamins (Cylaris, Iovate Health Sciences International) 1028 mg daily, taken in single or divided doses, for 8 weeks reduces weight by around 7% or 6.6 kg when used alone. When used with a reduced calorie diet, body weight is reduced by 8.5% or 8.1 kg (15608,15609,95921). It is unclear if these findings are due to Cissus quadrangularis, other ingredients, or the combination.

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Asthma. Although there has been interest in using oral Cissus quadrangularis for asthma, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Cancer. Although there has been interest in using oral Cissus quadrangularis for cancer, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Diabetes. Although there has been interest in using oral Cissus quadrangularis for diabetes, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Epilepsy. Although there has been interest in using oral Cissus quadrangularis for epilepsy, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Fractures. Several small, low-quality clinical trials suggest that oral Cissus quadrangularis may accelerate the healing of various types of fractures and reduce pain and swelling. Details: Two small clinical studies in patients with jaw fractures in India show that taking powdered Cissus quadrangularis whole herb 500 mg three times daily for 6 weeks or a different Cissus quadrangularis preparation containing dried stem 600 mg twice daily for 8 weeks reduces pain, swelling, and healing time when compared with placebo (93634,95923). In patients with single, simple bone fractures, a small clinical study in India shows that taking an Ayurvedic preparation of crude, powdered Cissus quadrangularis (Asthishrunkhala churna), 10 grams divided into three doses daily for 30 days, accelerates bone healing and reduces analgesic requirements when compared with placebo (95921). Another small clinical trial in patients with distal radius fractures shows that taking the same Ayurvedic preparation orally, 3-4 grams twice daily for 6 weeks, with or without a topical preparation of Cissus quadrangularis, 15 grams applied once daily for 2 weeks, seems to decrease subjective measures of pain and swelling when compared to baseline (95922). The validity of this finding is limited by the lack of a comparator group. In patients with a fracture of the long bones of the leg, a very small clinical study in India shows that taking a specific Cissus quadrangularis extract (Calzbone, Verdure Sciences) 250 mg orally three times daily decreases the average fracture healing time from 16-20 weeks to 12-14 weeks (43216). Cissus quadrangularis has also been evaluated in combination with other ingredients. A small, open label trial in India among patients with jaw fractures shows that taking Cissus quadrangularis 500 mg and Dalbergia sissoo 400 mg twice daily for 4 weeks improves bite force restoration when compared with placebo, but not when compared with teriparatide. Improvements in pain, fracture site mobility, and bone healing were lacking in all groups (112139). The study may have been inadequately powered to detect differences between the groups, and it is unclear if these findings are due to Cissus quadrangularis, Dalbergia sissoo, or the combination.
• Gout. Although there has been interest in using oral Cissus quadrangularis for gout, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Hemorrhoids. Small clinical studies suggest that oral or topical Cissus quadrangularis extracts may not improve symptoms of hemorrhoids. Details: Several small clinical studies in patients with acute, symptomatic hemorrhoids show that taking Cissus quadrangularis extract as either 100 mg daily for 1 week, 180 mg daily for 2 weeks, or 1 gram three times daily for 3 days followed by 1 gram twice daily for 4 days, does not improve symptoms of hemorrhoids when compared with placebo (43204,95921). Using a topical preparation of Cissus quadrangularis extract three times daily for 1 week also seems to be no better than placebo (95921). Another small clinical study in this population shows that rectal administration of a suppository containing Cissus quadrangularis extract 1% and Amcella paniculata extract 1% twice daily for 7 days results in similar improvements in anal pain, bleeding, and prolapse size when compared with a commercial suppository containing hydrocortisone 5 mg and cinchocaine 5 mg (108548). It is unclear if these findings are due to Cissus quadrangularis, Amcella paniculate, or the combination.
• Hyperlipidemia. Although there has been interest in using oral Cissus quadrangularis for hyperlipidemia there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Joint pain. It is unclear if oral Cissus quadrangularis is beneficial in patients with joint pain. Details: A small clinical study in males with exercise-related chronic joint pain shows that taking two 800 mg capsules of a specific Cissus quadrangularis product (SuperCissus, USPlabs) twice daily for 8 weeks decreases pain by 31% and stiffness by 23% when compared to baseline (93633). The validity of these findings is limited by the lack of a comparator group.
• Metabolic syndrome. Although there has been interest in using oral Cissus quadrangularis for metabolic syndrome, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Muscle strength. Although there has been interest in using oral Cissus quadrangularis to improve muscle strength, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Osteopenia. It is unclear if oral Cissus quadrangularis is beneficial for osteopenia. Details: A moderate-sized clinical trial in Thailand among postmenopausal patients with osteopenia shows that taking Cissus quadrangularis 1200 or 1600 mg daily for 24 weeks does not improve bone mineral density (BMD) when compared with placebo. However, Cissus quadrangularis does seem to improve markers of bone turnover, suggesting that longer-term use might lead to improvements in BMD (112140). Also, a small clinical study in patients with low BMD shows that taking a combination of Cissus quadrangularis, ashwagandha, and holy basil once daily for 6 months seems to improve BMD, T-score, and Z-score when compared with placebo (43217). However, it is unclear if these findings are due to Cissus quadrangularis, other ingredients, or the combination.
• Osteoporosis. Although there has been interest in using oral Cissus quadrangularis for osteoporosis, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Peptic ulcers. Although there has been interest in using oral Cissus quadrangularis for peptic ulcers, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Rheumatoid arthritis (RA). Although there has been interest in using oral Cissus quadrangularis for RA, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose.
• Wound healing. Although there has been interest in using topical Cissus quadrangularis for wound healing, there is insufficient reliable information about the clinical effects of Cissus quadrangularis for this purpose. More evidence is needed to rate Cissus quadrangularis for these uses.

(Read more about CISSUS QUADRANGULARIS)

POSSIBLY EFFECTIVE

• Athletic performance. Most available research suggests that oral tart cherry modestly improves muscular strength and endurance when compared with control. However, most studies are limited by a high risk of selection bias. Details: A meta-analysis of 14 small studies involving a total of 303 trained athletes and untrained healthy adults shows that tart cherry might modestly improve recovery of muscular strength and power when compared with control. Also, some subgroup analyses show that tart cherry may improve recovery of jump height and sprint time when compared with control (105629). In another meta-analysis of 10 studies involving 147 marathon runners, cyclists, or triathletes at various levels of training, taking tart cherry juice concentrate or powder 1.5 hours before exercise, or for up to 7 days prior to exercise, seems to improve exercise endurance, as measured by the time to complete an exercise trial, when compared with control (102340). However, both analyses have a high risk of selection bias and some analyses have high heterogeneity. Specific products assessed in the meta-analyses include tart cherry juice (CherryActive, Active Edge Nutrition) 60 mL, 90 minutes prior exercise (98699); a specific tart cherry concentrate (CherryActive, Active Edge Nutrition) 30 mL twice daily for 8 days (93149); and a specific freeze-dried tart cherry supplement (CherryPURE, Shoreline Fruit LLC) 480 mg daily 7 days before, on the day of, and 2 days after exercise (93158).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aromatase inhibitor-induced arthralgia. It is unclear if oral tart cherry is beneficial in patients with aromatase inhibitor-induced arthralgia (AIIA). Details: Preliminary clinical research in a small group of females with non-metastatic, hormone-receptor positive breast cancer and AIIA after taking aromatase inhibitors for at least 4 weeks shows that taking tart cherry juice concentrate 30 mL daily for 6 weeks reduces pain scores on a visual analog scale by about 35%, compared with 1% in those taking placebo (109657).
• Attention deficit-hyperactivity disorder (ADHD). It is unclear if oral tart cherry juice is beneficial in children with ADHD. Details: A small clinical study in children and adolescents aged 6 to 18 years with ADHD shows that consuming tart cherry juice concentrate 75 mL twice daily for 2 weeks with standard treatment does not improve ADHD symptoms including cognitive impairment, hyperactivity, impulsivity, or oppositional behavior when compared with placebo (112815).
• Cognitive function. It is unclear if oral tart cherry improves cognitive function. Details: Preliminary clinical research in healthy, middle-aged adults shows that taking tart cherry juice concentrate 30 mL orally twice daily for 3 months reduces mental fatigue and improves performance on tests evaluating sustained attention, psychomotor speed, and alertness when compared with placebo. However, it does not affect sleep quality or cerebral blood flow (109655).
• Exercise-induced muscle soreness. Research on the use of oral tart cherry juice or supplements for the reduction of exercise-induced muscle soreness is conflicting. Details: A meta-analysis of 12 small studies in trained athletes and untrained healthy adults shows that tart cherry might modestly attenuate delayed muscle soreness after exercise involving maximal muscle contractions or maximal effort sprints when compared with control. However, tart cherry juice seems to be no better than placebo for improving delayed muscle soreness after prolonged aerobic exercise (105629). These findings are limited by a high risk of selection bias, high heterogeneity, and imprecision. Some products assessed in the meta-analysis include a specific Montmorency tart cherry concentrate (Holland & Barrett Ltd.) 30 mL twice daily for 5 days before, on the day of, and for 2 days after intermittent sprint exercises (102341); a specific freeze-dried tart cherry supplement (CherryPURE, Shoreline Fruit LLC) 480 mg daily for 7 days before, on the day of, and 2 days after running a half-marathon or doing back squats (93157,93158); a specific Montmorency tart cherry juice concentrate (CherryActive, Active Edge Nutrition) 30 mL diluted in water and taken twice daily for 8 days (93149,93151,101880,102344); and a specific juice (Sour cherry juice, Cherrypharm Inc.) containing 90% tart cherry juice and 10% apple juice as a sweetener, twice daily (93152,93154). Some individual clinical studies have yielded mixed findings. One clinical study in professional rugby players shows that taking a Montmorency tart cherry juice concentrate gel, 30 mL (equivalent to 100 cherries) twice daily for 2 days before, on the day of, and for 2 days after a match does not improve muscle soreness when compared with placebo (102339). Similarly, in male professional soccer players, taking tart cherry juice, 60 mL before and after a 90-minute match and then 12 and 36 hours later, does not improve subjective muscle soreness when compared with placebo (102342). Also, a small study in healthy males shows that taking a specific tart cherry supplement (Tart Cherry Extract Powder NordicCherry, Specnova, LLC.) 500 mg daily for 7 days prior to performing resistance exercise does not reduce muscle soreness when compared with placebo (105631). In contrast, a small clinical study in recreational long-distance runners shows that drinking a specific tart cherry juice (Cherrish, Cherrish Corp.) 10.5 ounces twice daily for 7 days prior to a long-distance race decreases post-race muscle pain by around 65% when compared with placebo (93156). Reasons for the discrepancies may include differences in tart cherry products, the small number of subjects, and heterogeneity in study populations and evaluated endpoints. In some studies, the subjects' normal diets were continued during the study, whereas in others, a reduced polyphenol diet was consumed for the duration of the study (102342,105629).
• Exercise-induced respiratory infections. It is unclear if oral tart cherry juice reduces the risk of exercise-induced respiratory infections. Details: A small clinical study in recreational athletes shows that drinking a specific juice blend (Sour cherry juice, Cherrypharm Inc.), containing 90% tart cherry juice and 10% apple juice as a sweetener, 8 ounces twice daily for 5 days before, on the day of, and 2 days after running a marathon, decreases the risk for upper respiratory tract symptoms such as cough, sore throat, congestion, and sneezing when compared with placebo (93168).
• Fibromyalgia. It is unclear if oral tart cherry improves symptoms in patients with fibromyalgia. Details: A very small clinical study in females with fibromyalgia participating in an eccentric exercise program shows that taking a specific tart cherry concentrate (Cherrish, Cherrish Corp.) 10.5 ounces twice daily for 14 days does not improve pain or muscle strength when compared with placebo (93192).
• Gout. It is unclear if oral tart cherry juice reduces symptoms of gout; research is conflicting. Details: Preliminary clinical research shows that tart cherry juice lowers serum urate and increases urinary urate excretion in healthy people, as well as people with hyperuricemia that has not progressed to gout (93166,102338). However, in patients with gout, taking Montmorency tart cherry juice concentrate (Cherryvite) in doses of 7.5-30 mL twice daily for 28 days does not affect urate excretion or the frequency of gout flares (102343). A small, unblinded clinical study in adults with chronic gout shows that taking a combination product (GoutFighter, MaxBiocare Pty Ltd.) containing tart cherry fruit extract 100 mg, celery seed extract 300 mg, devil's claw tuber extract 150 mg, folic acid 90 mcg, potassium citrate 50 mg, and ascorbic acid 50 mg orally, as 2 tablets twice daily for 45 days, modestly reduces mean serum uric acid levels and reduces perceived pain and frequency of joint swelling when compared to baseline (106488). The validity of these findings is limited by the lack of a comparator group. Additionally, it is unclear if any effects are due to tart cherry, other ingredients, or the combination.
• Hypertension. It is unclear if oral tart cherry juice reduces blood pressure; research is conflicting. Details: A very small clinical study in males with mild hypertension shows that taking 60 mL of a specific tart cherry concentrate (CherryActive, Active Edge Nutrition) modestly decreases systolic, but not diastolic, blood pressure 1-3 hours after consumption when compared with placebo (93155). This finding is limited by the small study size and the use of a single dose. Another small study in healthy adults without hypertension shows that drinking 30 mL of Montmorency tart cherry concentrate (Cherry Marketing Institute) diluted in 240 mL of water daily for 3 months does not reduce blood pressure when compared with baseline or placebo (105633).
• Insomnia. Some small clinical studies suggest that oral tart cherry juice may modestly improve sleep and reduce insomnia. This effect might be due to the melatonin content in tart cherry juice. However, the evidence is conflicting. Details: A small clinical study in healthy adults less than 40 years of age shows that consuming a specific tart cherry juice concentrate (CherryActive, Active Edge Nutrition) 30 mL standardized to contain 1.42 mcg/mL of melatonin twice daily for 7 days modestly increases total sleep time and efficiency when compared with placebo (17199). Another small clinical study in adults aged 65 years and older with chronic insomnia shows that drinking a specific juice blend (Sour cherry juice, Cherrypharm Inc.), containing 90% tart cherry juice and 10% apple juice as a sweetener, 8 ounces twice daily for 14 days, modestly improves insomnia severity, but not sleep latency, when compared with placebo (17403). However, another very small clinical study in healthy adults shows that taking Montmorency tart cherry juice 240 mL twice daily or powdered Montmorency tart cherry capsules 1000 mg daily for 30 days does not improve sleep quality, sleep time, or serum melatonin concentration when compared with placebo (112813). The effects of tart cherry on sleep measures have also been evaluated in combination with other ingredients. A very small crossover study in healthy adults without a sleep disorder shows that taking a combination product containing tart cherry powder 220 mg, tryptophan, glycine, magnesium, and L-theanine 2 hours before bedtime for 3 nights decreases the time to fall asleep by about 24 minutes, increases total sleep duration by about 22 minutes, improves sleep efficiency, and reduces morning sleepiness, but does not improve the total time in bed or wakefulness after falling asleep when compared with placebo (111184). It is unclear if these effects are due to tart cherry, other ingredients, or the combination.
• Metabolic syndrome. Oral tart cherry juice does not seem to improve cardiovascular or metabolic biomarkers in patients at risk for or with metabolic syndrome. Details: Two meta-analyses of small, moderate-quality clinical studies in healthy adults, patients with metabolic syndrome, or those with risk factors for metabolic syndrome, that include many of the same studies, show that drinking tart cherry juice 30-480 mL daily for 1-12 weeks does not improve fasting blood glucose, insulin levels, lipid profiles, blood pressure, body weight, body mass index, fat mass, percentage body fat, or waist circumference when compared with placebo (112812,112814).
• Osteoarthritis. It is unclear if oral tart cherry juice is beneficial in patients with osteoarthritis. Details: A small clinical study in patients with osteoarthritis shows that drinking a specific juice blend (Sour cherry juice, Cherrypharm Inc.) containing 90% tart cherry juice and 10% apple juice as a sweetener, 8 ounces twice daily for 6 weeks, does not improve pain, stiffness, function, walking speed, or acetaminophen use when compared with placebo (93160). The validity of this finding is limited because the trial was not adequately powered to detect small differences between groups. More evidence is needed to rate tart cherry for these uses.

(Read more about TART CHERRY)

POSSIBLY SAFE ...when used orally and appropriately, short-term. Preparations of Cissus quadrangularis dried herb have been used with apparent safety in doses up to 1600 mg for 24 weeks (93634,95923,112140). An Ayurvedic preparation of the dried herb has been used with apparent safety in doses of 6-10 grams daily for 4-6 weeks (95921,95922). Some research shows that a specific Cissus quadrangularis product (SuperCissus, USPlabs) can be used safely in a dose of 3.2 grams daily for up to 8 weeks (93633). Other research shows that another specific Cissus quadrangularis extract (CQR-300; Gateway Health Alliance) has been used with apparent safety in a dose of 300 mg daily for up to 10 weeks (15609,16457,93637,99257).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

(Read more about CISSUS QUADRANGULARIS)

LIKELY SAFE ...when the fruit is used in amounts commonly found in foods. ...when tart cherry fruit, fruit juice, or fruit juice concentrate is used orally in supplemental amounts for up to 3 months (17403,93149,93151,93152,93153,93154,93156,93157,93158,93160)(93161,93168,93179,105633).

POSSIBLY SAFE ...when tart cherry fruit extract or powder is used orally, short term. Cherry fruit extract or freeze-dried cherry powder up to 500 mg daily for up 7 days has been used with apparent safety (93157,93158,105631). There is insufficient reliable information available about the safety of tart cherry stem when used orally.

PREGNANCY AND LACTATION: LIKELY SAFE
when the fruit is consumed in typical food amounts. There is insufficient reliable information available about the safety of tart cherry fruit or stem when used in medicinal amounts; avoid using.

(Read more about TART CHERRY)

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, Cissus quadrangularis might increase the risk of hypoglycemia when taken with antidiabetes drugs.  Details Small clinical studies suggest that Cissus quadrangularis might reduce fasting blood glucose in individuals with overweight or obesity (16457,99257).

(Read more about CISSUS QUADRANGULARIS)

(Read more about TART CHERRY)

General ...Orally, Cissus quadrangularis seems to be well tolerated.

Gastrointestinal ...Orally, Cissus quadrangularis has been reported to cause flatulence (15608,16457), diarrhea (15608,112140), gastritis (43204), and dry mouth (15608). However, the rates of these adverse effects are similar to or lower than that observed with placebo (15608,16457,43204,112140).

Neurologic/CNS ...Orally, Cissus quadrangularis has been reported to cause headache and insomnia. However, the rates of these adverse effects are similar to or lower than that observed with placebo (15608,16457).

(Read more about CISSUS QUADRANGULARIS)

General ...Tart cherry is generally well tolerated when consumed as whole fruit, juice concentrate, or seed extracts.
Most Common Adverse Effects:
Orally: Abdominal pain, asthenia, gastrointestinal upset, loose stools.

Endocrine ...One case of hyperglycemia after drinking a specific blend of tart cherry and apple juices ) has been reported (93160).

Gastrointestinal ...In a clinical study, 29% of children who consumed 75 mL of tart cherry juice concentrate twice daily for 2 weeks reported abdominal pain (112815). Two cases of loose stools after consumption of 90 whole tart cherries, and one case of gastrointestinal disturbance after drinking 10.5 ounces of tart cherry concentrate (Cherrish, Cherrish Corp.) twice daily for 14 days have been reported (93186,93192). One case of gastrointestinal symptoms after drinking a specific blend of tart cherry and apple juice (Sour cherry juice, Cherrypharm Inc.) has been reported (93160).

Immunologic ...One case of a skin reaction possibly due to cherry allergy after drinking a specific blend of tart cherry and apple juice ) has been reported (93160).

Musculoskeletal ...In a clinical study, 31% of children who consumed tart cherry juice concentrate 75 mLl twice daily for 2 weeks reported asthenia (112815).

(Read more about TART CHERRY)