The short answer
No studies found. We found no study of neem taken with lithium, and no evidence that neem changes lithium levels directly. Lithium has a narrow safe margin, and its label warns that losing body fluid (dehydration) raises the risk of lithium toxicity.
So a stomach upset with vomiting or diarrhoea, whatever the cause, matters more for someone on lithium. Memorial Sloan Kettering also lists poisoning with neem oil as a separate concern. If you take lithium, tell your prescribing doctor before you start a neem product, and ask whether your lithium level should be checked.
Lithium carbonate is sold in India as Lithosun.
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| No study of the pair; dehydration raises lithium levels in general[1] | Fluid loss, for example from a stomach upset, slows lithium clearance | Possible lithium toxicity; not shown for neem | Theoretical by mechanism |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Lithium label, United States Theoretical by mechanism
The lithium label lists volume depletion or dehydration among the conditions that raise the risk of toxicity, and calls for blood-level monitoring. It does not mention neem. We include it because it is the only source that bears on this pair.[1]
What your doctor may watch for
- Lithium level, kidney function and how well you are drinking and keeping fluids down.[1]
- Confusion, a marked tremor or an unsteady walk need urgent medical attention on lithium.[1]
What to tell your prescribing doctor
You can read this out, or show them this page:
“I am taking, or planning to take, neem (leaf powder, capsules, extract or juice, and how much) along with lithium. I could not find any study of the two together. Should my lithium level be checked, and what should I do if I get vomiting or diarrhoea?”
Withheld until review
Questions people ask
Is neem oil the same as neem leaf or juice?
No. Leaves, twigs, bark, extracts and oil are different products. Memorial Sloan Kettering flags poisoning from neem oil as its own concern, so tell your doctor exactly which form you use.[2]
Related
Gokshura (gokhru) and lithium
Tribulus may act as a diuretic, and lithium levels rise when the body loses water or salt. We found no study of the two together.
InteractionNeem and blood pressure medicines
Neem lowered blood pressure in rats, and in lab tests it blocked an enzyme that clears amlodipine. We found no study of neem with BP medicines.
InteractionPunarnava and lithium
We found no study of the pair. The worry is indirect: punarnava acts as a diuretic in animals, and fluid or salt loss can raise lithium levels.
InteractionShatavari and lithium
We found no study of the pair. Shatavari acted as a diuretic in rats at a high dose, and sodium loss from diuretics can raise lithium levels.
Sources
- Lithium oral solution, US prescribing information (DailyMed).
- Memorial Sloan Kettering Cancer Center. About Herbs: Neem. Herb-drug interactions and warnings.
Updated 4 November 2026
Taking neem with other medicines? A vaidya can check your full list.
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