SupplementPreliminary evidenceImmunity

Neem (Azadirachta indica)

Ayurvedic bitter for skin and digestive complaints, topical preparations have RCT signal for psoriasis and gingivitis; oral safety profile is the limit.

Why

Neem (Azadirachta indica) is one of the most-used herbs in Ayurveda, leaves, bark, and oil are all used. Topical preparations have small RCTs for plaque psoriasis (Charlsons 2015), gingivitis (Pai 2004), and head lice. Oral use is more constrained: documented hepatotoxicity from oral neem oil ingestion in children, and male reproductive toxicity in animal studies. Topical and dental use are the more defensible modern indications.

How it works

Multiple bioactive triterpenoids (azadirachtin, nimbin, nimbidin) with antimicrobial, anti-inflammatory and insecticidal effects. Topical mucosal effect in gingivitis is well-documented.

Expected onset · Topical effects over 4–8 weeks; dental effects within 2–4 weeks

How to take

Dosage

Topical cream or mouthwash: per product label. Oral powder: 3–6 g/day under specialist guidance only; not for self-administration.

Timing

Topical: twice daily. Mouthwash: after meals.

On the label

Neem topical cream or mouthwash for dental and skin indications. Oral neem powder only under specialist Ayurvedic guidance; oral oil is contraindicated.

Ideal for

Adults with mild plaque psoriasis, gingivitis, or head lice exploring topical options. Oral use only under specialist Ayurvedic guidance.

Safety

Oral neem oil ingestion in children has caused encephalopathy and liver failure, never give oral oil. Male reproductive toxicity documented in animal studies. Avoid in men trying to conceive. Pregnancy: contraindicated (abortifacient at higher doses). Hypoglycaemia risk. Topical and dental use have much better safety profile.

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Evidence

At a glance

Pai 2004 RCT (n=36): neem mouthwash reduced plaque and gingivitis indices comparable to chlorhexidine. Topical and dental use have clearer evidence base; oral neem use has documented safety concerns. Preliminary, RCTs exist in non-tier-1 journals but are small or short-duration. No Cochrane review, EMA monograph or EFSA-authorised claim covers the indication.

Limitations

Preliminary, RCTs exist in non-tier-1 journals but are small or short-duration. No Cochrane review, EMA monograph or EFSA-authorised claim covers the indication.

Where to get it

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