Neem

What other names is Neem known by?

Antelaea azadirachta, Arishta, Arishtha, Azadirachta indica, Bead Tree, Holy Tree, Huile de Neem, Indian Lilac, Indian Neem, Lilas des Indes, Lilas de Perse, Margosa, Margosa Tree, Margousier, Margousier à Feuilles de Frêne, Margousier d'Inde, Melia azadirachta, Neem Oil, Neem Tree, Melia azadirachta, Nim, Nimb, Nimba, Persian Lilac, Pride of China.

What is Neem?

Neem is a tree. The bark, leaves, and seeds are used to make medicine. Less frequently, the root, flower, and fruit are also used.

Neem leaf is used for leprosy, eye disorders, bloody nose, intestinal worms, stomach upset, loss of appetite, skin ulcers, diseases of the heart and blood vessels (cardiovascular disease), fever, diabetes, gum disease (gingivitis), and liver problems. The leaf is also used for birth control and to cause abortions.

The bark is used for malaria, stomach and intestinal ulcers, skin diseases, pain, and fever.

The flower is used for reducing bile, controlling phlegm, and treating intestinal worms.

The fruit is used for hemorrhoids, intestinal worms, urinary tract disorders, bloody nose, phlegm, eye disorders, diabetes, wounds, and leprosy.

Neem twigs are used for cough, asthma, hemorrhoids, intestinal worms, low sperm levels, urinary disorders, and diabetes. People in the tropics sometimes chew neem twigs instead of using toothbrushes, but this can cause illness; neem twigs are often contaminated with fungi within 2 weeks of harvest and should be avoided.

The seed and seed oil are used for leprosy and intestinal worms. They are also used for birth control and to cause abortions.

The stem, root bark, and fruit are used as a tonic and astringent.

Some people apply neem directly to the skin to treat head lice, skin diseases, wounds, and skin ulcers; as a mosquito repellent; and as a skin softener.

Inside the vagina, neem is used for birth control.

Neem is also used as an insecticide.

Insufficient Evidence to Rate Effectiveness for...

  • Dental plaque. Early research suggests that applying neem leaf extract gel to the teeth and gums twice daily for 6 weeks might reduce plaque formation. It also might reduce the number of bacteria in the mouth that can cause plaque. However, using a mouth rinse containing neem extract for 2 weeks does not appear to reduce plaque or gingivitis.
  • Insect repellant. Early research suggests that applying extract of neem root or leaf to the skin helps repels black flies. Also, applying neem oil cream to the skin seems to protect against some types of mosquitos.
  • Ulcers. Some research suggests that taking 30-60 mg of neem bark extract twice daily by mouth for 10 weeks helps heal stomach and intestinal ulcers.
  • Psoriasis. Early research suggests that taking neem extract by mouth for 12 weeks, along with daily sun exposure and the application of a coal tar and salicylic acid cream, reduces the severity of psoriasis symptoms in people.
  • Fever.
  • Upset stomach.
  • Breathing conditions.
  • Malaria.
  • Worms.
  • Head lice.
  • Skin conditions and diseases.
  • Heart disease.
  • Diabetes.
  • Birth control (contraception).
  • Other conditions.
More evidence is needed to rate the effectiveness of neem for these uses.

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How does Neem work?

Neem contains chemicals that might help reduce blood sugar levels, heal ulcers in the digestive tract, prevent conception, kill bacteria and prevent plaque formation in the mouth.

Are there safety concerns?

Neem is POSSIBLY SAFE for most adults when taken by mouth for up to 10 weeks, when applied inside the mouth for up to 6 weeks, or when applied to the skin for up to 2 weeks. When neem is taken in large doses or for long periods of time, it is POSSIBLY UNSAFE. It might harm the kidneys and liver.

Special Precautions & Warnings:

Children: Taking neem seeds or oil by mouth is LIKELY UNSAFE for children. Serious side effects in infants and small children can happen within hours after taking neem oil. These serious side effects include vomiting, diarrhea, drowsiness, blood disorders, seizures, loss of consciousness, coma, brain disorders, and death.

Pregnancy and breast-feeding: Neem oil and neem bark are LIKELY UNSAFE when taken by mouth during pregnancy. They can cause a miscarriage.

Not enough is known about the safety of need during breast-feeding. Stay on the safe side and avoid use.

"Auto-immune diseases" such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Neem might cause the immune system to become more active. This could increase the symptoms of auto-immune diseases. If you have one of these conditions, it's best to avoid using neem.

Diabetes: There is some evidence that neem can lower blood sugar levels and might cause blood sugar to go too low. If you have diabetes and use neem, monitor your blood sugar carefully. It might be necessary to change the dose of your diabetes medication.

Reduced ability to have children (infertility): There is some evidence that neem can harm sperm. It might also reduce fertility in other ways. If you are trying to have children, avoid using neem.

Organ transplant: There is a concern that neem might decrease the effectiveness of medications that are used to prevent organ rejection. Do not use neem if you have had an organ transplant.

Surgery: Neem might lower blood sugar levels. There is a concern that it might interfere with blood sugar control during and after surgery. Stop using neem at least 2 weeks before a scheduled surgery.

Are there any interactions with medications?



Lithium
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Neem might have an effect like a water pill or "diuretic." Taking neem might decrease how well the body gets rid of lithium. This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.



Medications for diabetes (Antidiabetes drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Neem might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking neem along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.



Medications that decrease the immune system (Immunosuppressants)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Neem might increase the immune system. By increasing the immune system, neem might decrease the effectiveness of medications that decrease the immune system.

Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.

Dosing considerations for Neem.

The appropriate dose of neem depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for neem. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Last Editorial Review: 3/29/2011