If you’ve been struggling with PMS symptoms, heavy periods, acne, breast tenderness or symptoms of PCOS or perimenopause then you’ve probably come across a DIM supplement as a solution. That’s because DIM supports healthy estrogen levels in the body.
In this article
What Are DIM Supplements?
DIM is short for diindolylmethane, a metabolite of indole-3-carbinol. DIM1 is a compound that can only be made from cruciferous vegetables. When broccoli, cauliflower, and other cruciferous vegetables are exposed to stomach acid after chewing, indole-3-carbinol is created, which is then converted into DIM.
While DIM can be derived from food, it would take eating a whole lot of broccoli to match what can be found in a supplement. That is why many people take a concentrated amount in the form of a supplement.
DIM supplements also skip the entire process of converting it to its active form and deliver the specific nutrient.
As I’ll explain in this article, DIM supports the body in producing more favorable estrogen metabolites, specifically 2-hydroxy estrogen (2OH).
It also can inhibit the conversion of testosterone to estrogen, which may help balance these two hormones.
This nutrient has a lot of potential hormonal health benefits for women — particularly in the case of excess estrogen, which is why many people opt for the supplement.
Keep reading if you’re experiencing:
- Breast tenderness or fibrocystic breasts
- PMS
- Heavy periods
- Painful periods
- Bloating before your period
- Difficulty with weight gain on your hips, butt, or thighs
- Fibroids
- Endometriosis
- Adenomyosis
- Perimenopause
- Menopause
- Hair loss, or hair popping up where you don’t want it
What Does DIM Do For Hormones?
One of the most significant things DIM may do for women is improve estrogen metabolism2. Estrogen imbalance or excess estrogen, often called “estrogen dominance” can lead to a cascade of undesirable symptoms like hormonal headaches, breast tenderness, and PMS, to name a few.
What Is Estrogen Dominance?
Put simply, estrogen dominance refers to a situation where there is too much estrogen in the body in general or when there is too much estrogen relative to progesterone (i.e. there is not enough progesterone to oppose estrogen).
I’ve written at length about estrogen dominance and the impact it may have on the body. Estrogen dominance could unfortunately come about for various reasons: anovulation (no ovulation), stress, adrenal issues, excess fat in the body, the environment, digestive problems, and autoimmune conditions.
This can result from the ovaries or other tissues producing too much estrogen, testosterone being converted into estrogen, or from poor metabolism of estrogen itself.
Symptoms of estrogen dominance can include:
- Irritability
- PMS
- Weight gain
- Heavy periods
- Painful periods
- Fibrocystic breasts
- Fibroids
- Endometrial hyperplasia
- Water retention
In some instances, estrogen can look normal in labs but the metabolites that are produced in the liver can be problematic. More on that soon.
Now, I just want to clear something up. I know estrogen is often demonized, but we need estrogen! It’s an essential hormone for women, and is responsible for so much good stuff — like cognition3, protecting our bones4, and helping us have healthy pregnancies5. But, like all hormones, it needs to be balanced. So the goal would not be to drop estrogen as low as possible.
Problems can arise when there is too much estrogen circulating in our bodies or the wrong metabolites.
What Does DIM Do To Your Estrogen?
To understand how DIM supports your estrogen we first have to understand how estrogen is metabolized.
When your body no longer needs estrogen it is the liver’s job to package it up so it can be sent out via the urine and stool. Within the liver there are two steps to estrogen metabolism known as Phase 1 and Phase 2 detox.
During Phase 1 your liver converts estrogen into 3 metabolites—2 hydroxy estrone (2OHE1), 4 hydroxy estrone (4OHE1), and 16 hydroxy estrone (16OHE1). The most favorable of the three is 2OHE1. The other metabolites, 4OHE1 and 16OHE1 are associated with unfavorable growths of breast and uterine tissue, including cancer.
In Phase 2 detox these metabolites are methylated and prepared for excretion via the kidneys and bowels. Many people mistakenly think that the liver is the only organ involved in estrogen metabolism and while it is very important, so is the health of your kidneys and bowels. This is why drinking ample water, eating fiber, supporting microbiome health, and ensuring regular bowel movements is so important to your hormone health.
How Does DIM Affect Your Estrogen?
DIM works at the Phase 1 detox level to help your liver make the most favorable metabolite, 2OHE1 and reduce the excess production of potentially harmful 4OHE1 and 16OHE1.
Potential Benefits Of DIM Supplements
Studies on DIM have shown promise for breast health, acne, and reducing PMS. There is also data to support its benefits in certain cancers. DIM may be helpful for breast health because it supports Phase 1 metabolism of estrogen in the liver, favoring 2OHE1. Although there is research and anecdotal evidence to suggest benefits, it is important to note that more data is needed.
DIM For Breast Health
DIM supports liver enzymes that may help with Phase 1 estrogen metabolism6, which is the phase that packages hormones and toxins up for elimination.
The best estrogen metabolite is 2-hydroxy estrone (2OHE1), which DIM promotes over the problematic estrogen metabolite, 16 alpha-hydroxy estrone (16OHE1). When estrogen moves down the 16OHE1 pathway, mastalgia (breast pain) may result. Keep in mind that 16OHE1 is the type that can lead to mastalgia and may stimulate estrogen-sensitive cancer cells, like breast cancer.
A double-blind, randomized controlled study showed that 150 Pharmaceutical researchers are taking note and testing indole carbonil-based formulations7 for mastalgia.
DIM In Estrogen Receptor Positive Breast Cancer
It is also important to note that 16OHE1 metabolites could also stimulate estrogen-sensitive cancer cells, which if left unchecked, could lead to breast tumors8.
In a randomized, placebo-controlled trial9, women prescribed tamoxifen10 (a treatment for hormone-receptor positive breast cancer) were either assigned 150 mg of an oral DIM supplement or a placebo for a 12-month period. DIM increased the 2OHE1 ratio compared to the placebo with minimal adverse effects. Researchers concluded that, in women taking tamoxifen, DIM promoted healthier estrogen metabolite production.
DIM For PMS
While this is not true for everyone, the root cause of PMS could be due to estrogen dominance. If you are struggling with heavy periods, tender breasts, mood swings, hot flashes and water retention, there is a high chance that you are estrogen dominant. That’s the bad news.
And supplementation may sometimes be a useful tool in helping the body optimize your hormones. Because it helps regulate estrogen, DIM is a great supplement to look into for women experiencing PMS and period problems (such as cramps and heavy periods), especially when combined with nutrients like calcium and herbs like Vitex.
Read more about supplements for PMS here.
DIM For Heavy Periods And Cramps
As we’ve discussed, estrogen can stimulate tissues to grow, which includes the endometrium. When the endometrial lining is overstimulated it can result in endometrial hyperplasia, which can lead to heavier periods.
Fibroids, polyps, and endometrial lesions, like those seen in endometriosis, can also be stimulated by estrogen. This can result in painful cramps, heavy periods, pain with sex, and spotting between periods. Left untreated, these conditions can progress and require surgery.
The good news is that you don’t always need to rely on painkillers or the pill as the only treatment for these conditions. You can take action at home by beginning to incorporate cruciferous vegetables, fiber, and other nutrients to support your hormones. You can get started with this free recipe guide and meal plan.
While we understand the mechanism by which this may work and many women report benefits, it is important to note that research is lacking.
The Potential Of DIM For Thyroid Proliferative Disease
A pilot study11 showed that DIM is an effective estradiol modulator (estradiol is a form of estrogen). In the study, a small sample of patients with thyroid proliferative disease (which includes cancer, goiter and adenoma) were given 300 mg of DIM daily for two weeks. It’s important to note that a higher dose of DIM was used because this was a study on patients with thyroid proliferative disease.
In the pilot study I mentioned first, urine analysis showed that DIM regulated estrogen metabolism in patients. After two weeks of taking DIM, patients with thyroid proliferative disease had more good estrogen metabolites, which results in more balanced hormones. After two weeks of supplementation, the ratio of 2OHE1 (the more beneficial estrogen metabolite) to 16OHE1 (a metabolite associated with the growth of tissue) increased, which is a shift in the right direction.
Hold up. What does the thyroid have to do with estrogen? Another study12 shows that increased levels of 16OHE1 may lead to a greater chance of thyroid proliferative disease.
DIM For Perimenopause And Menopause
Perimenopause is the period between a woman’s later reproductive years and menopause13. Periods will start to become irregular, until they disappear altogether. After a year without a period a woman is considered to be in menopause.
During both perimenopause and menopause, hormone patterns begin to change. One of those hormones is — you guessed it — estrogen. While in perimenopause, a woman’s progesterone levels will begin to decline as her ovulation is less regular. Left unchallenged, estrogen is allowed to stimulate tissues and as it goes through its own peaks and troughs, it can trigger hot flashes, night sweats, and mood swings. Once in menopause a woman’s estrogen will decline14.
We know an imbalance of estrogen and progesterone is not ideal at any time, but during the perimenopausal period, it often dramatically affects a woman’s quality of life. Studies have shown15 that women in perimenopause and menopause experience a reduced health-related quality of life, as well as higher work impairment.
And that’s where DIM comes in. As I’ve already mentioned, DIM promotes the production of more beneficial estrogen metabolites (2OHE1), and discourages the production of problematic estrogen metabolites (such as 16OHE1). By helping the body maintain a more favorable estrogen profile, DIM may help mitigate the symptoms of perimenopause and menopause when the culprit is estrogen imbalance.
Support Healthy Testosterone Levels
DIM may be effective at inhibiting aromatase16. Aromatase is an enzyme that assists in the conversion of testosterone to estrogen. This is why DIM can possibly prevent the excess production of estrogen and support healthy testosterone levels.
DIM may also inhibit DHT, a form of testosterone that is five times more potent than testosterone. DHT is the form of testosterone associated with prostate cancer17 in men and conditions like hirsutism (hair where you don’t want it) and acne in women.
How Much DIM Do I Need?
Eating a diet rich in cruciferous vegetables may supply you with the DIM your body needs to support healthy estrogen metabolism. Remember that it requires you to chew well and have healthy hydrochloric acid levels present in the stomach. While a DIM supplement may be helpful for some women, it is not essential for everyone. The best way to determine how much DIM you specifically need is to have lab testing that includes estrogen and estrogen metabolites.
There is research18 showing the benefits of eating cruciferous vegetables, but understand when DIM is specifically looked at, all the benefits come from supplements.
DIM Dosage
Typically, DIM supplements come in 50–300mg capsules. Starting with a lower dose of 50-100 mg is often best to avoid headaches, which can occur when you begin supplementing with DIM. Work with your doctor to determine whether DIM supplementation could be beneficial for you, and to determine the right dose for your body.
Food Sources Of DIM
Cruciferous vegetables contain Indole-3-Carbinol (I3C), which is converted to DIM by the body.
I3C is found in cruciferous vegetables, such as19:
- Broccoli
- Cauliflower
- Brussels Sprouts
- Kale
- Cabbage
- Watercress
- Garden cress
- Mustard greens
- Horseradish
- Turnips
- Bok choy
- Kohlrabi
You will not get as much DIM from a vegetable as you would from a capsule. For example, to obtain the dosage of 100–300mg of DIM recommended for women, you’d need to eat a lot more broccoli and cabbage than you might want to.
Should You Take DIM Everyday?
In order to see the benefits, DIM should be taken daily for at least 30 days. Daily supplementation is best if you’re going to use DIM.
Drug Interactions With DIM
Diindolylmethane may help the liver20 work more efficiently, so if you’re on prescription medication that the liver is primarily responsible for breaking down, it’s possible that your medication may not stay in your system long enough to be effective. Always let your doctor and pharmacist know if you’re taking DIM and any other supplement so that they can advise you about interactions.
Excessively high amounts of DIM may deplete sodium, an essential nutrient. It takes a lot of DIM to mess with your sodium on its own, but if you’re taking diuretics, you might reach your limit faster. Again, let your doctor know you’re taking DIM if you’re on any other medications, whether prescription or over-the-counter.
Supplements With DIM
DIM can be taken on its own or in a combination formula with other estrogen supporting nutrients. While DIM alone can help with Phase 1 detox metabolites, it is best taken in a supplement that contains Phase 2 detox nutrients like folate, B12, and magnesium. This can help prevent headaches and other unwanted issues that can arise when using a Phase 1 nutrient alone. In addition, having calcium d-glucarate available can ensure your bowels are able to effectively move the estrogen metabolites created by the liver out of the body.
In cases of microbial dysbiosis in the gut it is possible for an enzyme known as betaglucuronidase to reactivate the metabolites created in the liver and put estrogen back into circulation. Calcium d-glucarate mitigates the effect of betaglucuronidase. It’s important to support the entire system of estrogen metabolism.
Balance Women’s Hormone Support
Balance – Women’s Hormone Support is a comprehensive formula designed to help support a healthy hormone balance of estrogen, progesterone and testosterone in women. It contains ingredients that support Phase 1 and 2 estrogen metabolism in the liver, as well as calcium d-glucarate to ensure the body is able to safely remove estrogen from the body.
Learn more about Balance – Women’s Hormone Support.
DIM, The Hormone Helper
DIM is a compound with a myriad of potential hormonal health benefits for women. By modulating estrogen and estrogen metabolism, DIM may help women with various hormonal difficulties.
Because it helps move estrogen down the pathway that produces more favorable estrogen metabolites, DIM may be useful for women struggling with estrogen dominance, PMS, period problems, perimenopause, and menopause. It may also help maintain breast health and could prevent painful breasts (mastalgia).
Have you tried DIM? Let us know in the comments.
References
- https://www.mskcc.org/cancer-care/integrative-medicine/herbs/diindolylmethane ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048776/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318702/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/25555470/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376705/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059820/ ↩︎
- https://en.aig-journal.ru/articles/Indolkarbinol-Indinol-Forto-metod-multitargetnoi-terapii-pri-ciklicheskoi-mastodinii.html ↩︎
- http://d-scholarship.pitt.edu/7073/ ↩︎
- https://www.ncbi.nlm.nih.gov/pubmed/28560655 ↩︎
- https://www.breastcancer.org/treatment/druglist/tamoxifen ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048776/ ↩︎
- https://www.ncbi.nlm.nih.gov/pubmed/16730526 ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834516/ ↩︎
- https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-hormone-levels ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820128/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059820/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/12665522/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4354933/ ↩︎
- https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/indole-3-carbinol#food-sources ↩︎
- http://therapy.epnet.com/nat/GetContent.asp?siteid=EBSCO&chunkiid=104670 ↩︎