Neem

Azadirachta indica Neem Use The uses of neem are remarkably diverse. In India, the sap is used for treating fevers, general debilitation, digestive disturbances, and skin diseases; the bark gum for respiratory diseases and other infections; the leaves for digestive problems, intestinal parasites, and viral infections; the fruit for debilitation, malaria, skin diseases, and intestinal parasites; and the seed and kernel oil for diabetes, fevers, fungal infections, bacterial infections, inflammatory diseases, fertility prevention, and as an insecticide.1,2 However, there is no reliable research evidence to support any of these uses. As with many plant products, test tube studies indicate that, on direct contact, neem can kill or inhibit the growth of bacteria, fungi and viruses.4-8 This does not mean, however, that neem acts as a systemic antibiotic if it is taken by mouth. Neem mouthwash or chewing gum might be helpful for preventing cavities, because it can directly come in contact with cavity-causing bacteria,4,8 but this has not been proven. On the basis of extremely preliminary evidence, neem has also been advocated as a treatment for diabetes.9 Safety Issues Based on its extensive traditional use, neem seems to be quite safe. However, formal safety testing has only involved neem oil, the insecticide product made from the plant. While neem has been found adequately safe for use as an insecticide, animal studies suggest that long-term oral use of neem oil might produce toxic effects.10,11 In addition, other animal studies suggest that whole neem extract (which includes more substances than neem oil) may damage chromosomes, at least when taken in high doses or for an extended period of time.3,12 For all these reasons, as well as the lack of comprehensive safety investigation of neem products other than neem oil, we recommend that young children, pregnant or nursing women, or individuals with severe liver or kidney disease avoid use of neem.