Let's Learn About DIM!
Today I'd like to discuss a supplement that you may or may not have heard of: Diindolylmethane (DIM).
This is a supplement that I have used myself, and I wanted to highlight some of its benefits and applications! This post will focus on estrogen metabolism and the effects of DIM supplementation on women's health.
What is DIM (Diindolylmethane)?
DIM can be present in cruciferous vegetables like broccoli, cauliflower, cabbage, and brussel sprouts. Even if you consume a lot of these vegetables, you won't get the benefits of a supplement in your diet. When these vegetables are exposed to stomach acid after chewing, they produce indole-3-carbinol, which is then transformed into DIM.
Potential Benefits from DIM:
Reduction of PMS symptoms
Reduction of heavy periods/ cramping
Support perimenopause and menopause
DIM has a major impact on estrogen metabolism. Estrogen is a hormone generated by the body that regulates the menstrual cycle. However, it has an impact on a variety of body systems including reproduction, respiratory, heart/blood vessels, urinary tract, bones, breast tissue, skin, hair, pelvic muscles, and brain function.
The body demands an estrogen balance, which can be difficult due to the monthly variations caused by the menstrual cycle. Estrogen is a naturally occurring hormone that is supposed to fluctuate. There are a variety of conditions associated with consistently high or low estrogen. It’s important to note that to truly know your levels; blood work is required.
Female sexual dysfunction / vaginal dryness
Perimenopause / Menopause
Fibroids or Polyps
Your Estrogen Metabolism
To understand how DIM works, you must first understand what estrogen is and how it is metabolized in the body (processed/utilized). When your body has had enough estrogen, it sends it to the liver to be eliminated through urine or stool. There are two phases of detox – Phase 1 and Phase 2.
Phase 1: Your liver converts estrogen into 3 metabolites (products).
2 hydroxy estrone (2OHE1)
4 hydroxy estrone (4OHE1)
16 hydroxy estrone (16OHE1)
2OHE1 is the most favorable metabolite. 4OHE1 and 16OHE1 are the "bad" metabolites, for lack of a better term. They can cause mastalgia (breast pain) and activate estrogen-sensitive cancer cells if left untreated. During Phase 1, DIM aids in the production of more 2OHE1, resulting in a better ratio of good to bad metabolites.
According to another study, "DIM supplementation alters estrogen urinary metabolite profiles in women and has androgen-antagonistic effects." This implies that it has been demonstrated to successfully remove "bad" estrogens while simultaneously providing a mechanism to reduce androgens, which also contribute to painful periods, cramping, and other symptoms.
Let's move on from the boring biochemistry... How can DIM assist you?
To summarize, high estrogen levels are commonly related to the "negatives" of our menstrual cycles, such as heavy bleeding, cramping, and headaches, as well as the scarier stuff, such as endometriosis, fibroids, and breast cancer.
Adding a DIM supplement can help support you throughout these phases and make the experience of getting your periods a little bit easier. You typically need to take it consistently for at least a month to notice changes and then continually supplement as needed; talking to your healthcare provider as needed.
DIM supplements are available in quantities ranging from 50 to 300mg. To avoid headaches, it is advisable to begin with smaller doses while also working with a health professional. For example, the Thorne Labs "DIM Advantage" that we carry in the office contains 150mg of each capsule. It has the added benefit of containing sulforaphane glucosinolate which is another chemical derived from cruciferous vegetables that has been proven in research to have antioxidant, antibacterial, anticancer, anti-inflammatory, anti-aging, and neuroprotective properties.
There have been a variety of studies regarding the effects of DIM on the body. More research is needed but a few of the studies showed promising results:
Apoptosis (death) of pancreatic cancer cells and enhanced effects of Erlotinib (a chemotherapy drug).
In colon cancer and prostate cancer cells, DIM inhibits CDK (responsible for making new cells) activities and induces apoptosis by downregulating (getting rid of) survivin (a gene that is shown in a variety of cancers).
It also inhibits prostate cancer cell proliferation and induces apoptosis (this is a supplement that men can utilize as well to help with hormone balance.
Side effects or risk factors:
DIM can have an impact on certain drug classes making them less effective- specifically: CYP450 substrate drugs and MDR1 substrate drugs. These are certain drug classes that can be discussed with the provider who prescribed them.
It can impact sodium quantities when taken in excessive doses (ideally you will not be taking anywhere close to the quantity that would cause this but it is important to note especially for people who are taking diuretics.
It should not be taken if you are pregnant, planning to get pregnant, nursing, or taking hormonal birth control pills due to the impact it has on estrogen.
Women's bodies produce less estrogen following menopause. As a result, DIM may not be of much use. However, estrogen is not just a feminine hormone as many people believe. DIM is beneficial to men as well. Some of their testosterone is converted to estrogen and processed by the liver. In the worst-case scenario, DIM may worsen osteoporosis (bone thinning) by impairing your body's capacity to maintain healthy bone density.
Even if you consume a lot of vegetables, you may not receive enough DIM if you don't include cruciferous vegetables on a daily basis. All medications and supplements have a risk of interacting with one another, and DIM is no different. Always talk to your doctor before adding a supplement to your diet.
By: Dr. Abby Kellogg
Chiropractor at ANH Wellness
Disclaimer: "The information including but not limited to text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment."
Sources: https://www.hopkinsmedicine.org/health/conditions-and-diseases/estrogens-effects-on-the-female-body https://www.webmd.com/vitamins-and-supplements/health-benefits-dim https://drbrighten.com/dim-supplement/ https://www.mskcc.org/cancer-care/integrative-medicine/herbs/diindolylmethane https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225737/