Well, the Neem oil that I bought it just Neem oil nothing else. But hey if it doesnt work for you, it doesnt for you! 
I'm currently using SkinCeuticals Phyto for hyperpigmentation. How is the saw palmetto? I'm thinking about starting that in addition to my B5, Spearmint and red clover intake. I have switched to drinking distilled water too. Since using neem my skin has been flaking off and not in a bad way!!
I wish I had more advice for you, I'm sort of at a stalemate with my treatment, seeing how it goes. I can say though that I havent developed any new acne like I used to, and any cysts that I feel usually go away by themselves. You don't eat sugar right?
Yeah, my skin is very stubborn and rarely responds to topicals...so frustrating. SkinCeuticals' phytocorrective was working for me the first few days, and then nothing....it actually clogged my pores a bit, although I was careful about only applying it to acne-prone areas.
Saw palmetto is helping, but I'm still trying to figure out the correct dosage for my body. How are your supplements working? I used to drink lots of spearmint tea, but all it did for me was make me bloated and did not help my acne. Too bad because many people have seen results with it.
Btw, what brand of neem are you using?
And no, I try not to eat sugar but I'll usually have a few ginger or peppermint candy drops (low sugar) or brown rice sweetened with stevia if I feel dizzy...my blood sugar tends to drop, so these help me keep it under control.
T
The neem oil I use is called Theraneem. The use of apple cider vinegar (with the mother), spearmint tea and red clover tea, and B5 have shown me results. All but this one stubborn side of my face is clearing, and the bad side has mostly acne marks which are slowly fading. Mint tea is usually an anti-bloat herb, are you sure it wasnt because of something else taken in conjunction?
I used to get terrible blood sugar drops, up until this year actually. I drank wine, ate a lot of carbs, and even though I did not drink soda, still had enough sugar in my diet to be considered bad. So I decided to switch to no sugar, no carbs diet. The only carbs I eat are vegetables and purple potatoes. I also cut down my dairy to nil and quit all refined sugar. The first two weeks were horrible. I felt like crap all the time, fever, sweats, fatigue. However, after I detoxed from years of sugar and carb consumption, I felt 100x better. Brown rice with sugar is a terrible way to treat low blood sugar. It only causes a spike. Imagine a graph going from low, passing the base line, and rocketing up. To avoid the horrible detox I had you can always try to cut down slowly. I keep almond butter packs handy from Adams (not sure what grocery stores you have access to). I don't know you, and I'm not a doc, but I can speak from my own experience that this new lifestyle has helped me immensely. I hardly even consume fructose (fruit sugar). My energy is up, and my skin is clearing. I eat lots of organic meats and veggies and my waistline is actually slimming down (I do Zumba twice a week and ride horses too once a week).
I feel your frustration, dont give up, and feel free to discard/use any of my advice, everyone is different!
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