Category Archives: Herbal Remedies

Herbs and Salicylates

Neem & Margosa Oil

Margosa or Neem Oil

Margosa or Neem oil is a yellow oil with a disagreeable smell and bitter taste that has been used as a medical remedy in India and Southeast Asia for several centuries.  In recent years, there have been rare reports of acute onset of severe metabolic acidosis, hepatic and multiorgan failure and death following ingestion of margosa oil.


Margosa oil is an extract of the seeds of Azadirachta indica, commonly known as the Neem tree native to India and



Sri Lanka.  In low doses, margosa oil has been a traditional remedy for centuries in India and Southeast Asia used in treating asthma, intestinal parasites, arthritis and leprosy.  It is also an insecticide.  The oil has a disagreeable smell and bitter taste attributable to volatile sulphur compounds and fatty acids.   The bitters are secondary products formed during storage of the oil or the seeds and concentrations can vary in different commercial samples.


Margosa oil can cause severe metabolic acidosis and death, particularly in young children.  Symptoms of nausea, vomiting and progressive stupor develop within hours of consumption, followed by severe metabolic acidosis, coma, and progressive hepatic dysfunction, similar to Reye Syndrome.  Serum aminotransferase levels are generally normal or minimally elevated initially, but then rise to high levels accompanied by increases in LDH and CPK levels.  Progressive hepatic encephalopathy and cerebral edema develop within days.   This product contains high levels of salicylates – the same as aspirin.  Therefore, this product could trigger Reye’s Syndrome and should not be given or used by children under the age of 19.

Again, we urge extreme caution in using herbal remedies, and always check for salicylates in any product given to children under the age of 19.











Mechanism of Injury

The mechanism of hepatotoxicity of margosa oil appears to be related to mitochondrial dysfunction and poisoning of the electron transport pathway by a component of margosa oil or a contaminant.  A similar syndrome has been induced in laboratory animals with samples of the implicated oil.

 Other Names:  Neem oil

Other links:

What is Reye’s Syndrome

Aspirin Containing Products

Other Names for Aspirin

Pepto-Bismol and Children

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Know Your Herbs; They Could Kill You

Salicylates have long been known as water soluble compounds derived from a number of plants, particularly Willow and Meadowsweet with analgesic, antipyretic and anti-inflammatory properties, and comprises the main ingredient in aspirin.

Free salicylic acid and trace quantities of related phenolic glycosides are widely distributed among many foods, particularly fruits. Due to the minute concentrations involved these plants are considered unimportant as medicinal herbal sources of salicylates and are not listed here.

Some authorities consider the ingestion of these foods to be associated with various conditions, notably Attention Deficit issues in children.

Common salicylate-containing herbs:

• Betula lenta (Sweet Birch)

• Betula pendula (White birch)

• Filipendula ulmaria (Meadowsweet)

• Gaultheria procumbens (Wintergreen)

• Populus balsamifera (Balsam Poplar)

• Populus nigra (Black Poplar)

• Populus candicans (Balm Of Gilead)

• Salix alba (White Willow)

• Viburnum prunifolium (Black Haw)

Neem is the newest ‘craze’ in natural healing ingredients.  Neem proponents state that it can cure some 40 different diseases.

What you need to know is that  Neem contains compounds similar to those in aspirin and should not be used to treat children with fevers, or taken by people with known allergies to aspirin and aspirin like substances.

Neem should not be taken by anyone who is pregnant or trying to conceive.

Neem oil should not be taken internally.

So, please, learn all you can about that herbal ingredient before you use it, especially with a child; it could just save your life, or the life of a loved one!

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