When Do I Take DIM?
DIM (or diindolymethane) is a popular ingredient often added to supplements that focus on estrogen detoxification. It ultimately comes from the cruciferous family, such as cauliflower and broccoli, and supports phase 1 detoxification.
What does that mean?
The estrogens in your body go through a multi-step detoxification process. The purpose of this is to break down the estrogens into products known as metabolites that must be neutral and water soluble. This makes it easier for your body to eliminate them in your stool or urine. Because it’s a multi-step process, there are some pathways that are more helpful to the body and others that have risks or side effects associated with them. Supplements and foods, such as DIM and broccoli, partially help this process BUT not everyone needs DIM!
Let’s do a quick overview of your estrogen detoxification process.
It usually happens in the liver and then moves from your bile into your intestines or out into your blood and then into your kidneys. Right away, you can see how liver, intestinal, and kidney health are so important!
In phase 1, your estrogens estrone (E1) and estradiol (E2) first move through a fancy process known as hydroxylation. When it does this, different enzymes play a role and help direct it down to varying degrees down three different pathways. Not all pathways are ideal though!
Imagine you’re trying to walk home to your house and there are three paths you can choose. One is a straight shot and easy. Another one takes you through a crazy scary obstacle course that might hurt you. And the third route is usually okay but sometimes, depending on the situation, it’s a problem path for you.
In hydroxylation it’s similar. The three pathways are known in short-form as 2-OH, 4-OH, and 16-OH. They -OH is a hydroxy group which is why we called it hydroxylation.
The 2-OH pathway is the preferred pathway. And while something COULD go wrong on this path, it’s usually an easy straight shot.
The 4-OH pathway is NOT the preferred path. If your estrogens continue on this path without any help from specific enzymes and antioxidants, it might increase your risk for DNA damage which is not good.
The 16-OH pathway is a mixed pathway. While it can be helpful to bodily functions such as bone health, it also might encourage breast cancer cells to grow.
You don’t want these hydroxylation pathways to stay stuck here - you want them to KEEP GOING on to the next phase known as phase 2.
However, supplements such as DIM (and other supplements like Indole-3-carbinol or I3C), help direct the estrogens down the straight shot and easy path, 2-OH. This is why you probably have seen or read so much about it for women’s health.
Now, hold on!
Before you press ‘buy’ on that online supplement store, please know DIM is only part of the story!
You don’t want to take DIM if your phase 2 or phase 3 are stuck or having problems!
Let’s discuss my Bathtub Analogy for Estrogen Detoxification. If you picture yourself in a beautiful clawfoot bathtub, the water pouring in is phase 1. The drain is phase 2 and the sewer line taking it away from your house is phase 3.
In your body, phase 3 are your intestines and your kidneys - the organs of elimination, just like your sewer line. This means if you’re not hydrated, having kidney issues, struggling with constipation, having bile or gallbladder issues, or having overall intestinal problems, you’re likely going to struggle to properly eliminate your estrogen.
Therefore, don’t start with DIM until you clean up and clear out your sewer line! DIM will likely only make you feel WORSE over time! It’s like continuing to run a bath but the sewer line is plugged. The water will back up and ruin your bathroom floor! Yuck!
If your practitioner has suggested DIM as part of your supplement mix, make sure they understand the different phase of detoxification. I always start with the kidneys and intestinal microbiome BEFORE moving up through the phases.
Lastly, I don’t usually use DIM in my menopausal or low estrogen women except in certain cases. It can drive their circulating levels of estrogen lower! If you’re in menopause and taking DIM or its precursor I3C, be aware you might be lowering your levels of estrogen overall.
References:
Rajoria S, Suriano R, Parmar PS, et al. 3,3′-Diindolylmethane Modulates Estrogen Metabolism in Patients with Thyroid Proliferative Disease: A Pilot Study.Thyroid 2011;21(3):299-304. doi:https://doi.org/10.1089/thy.2010.0245
Thomson C, Chow S, Roe D, et al. Effect of Diindolylmethane on Estrogen-related Hormones, Metabolites and Tamoxifen Metabolism: Results of a Randomized, Placebo-controlled Trial. Cancer Epidemiology Biomarkers & Prevention. 2017;26(3):435.1-435. doi:https://doi.org/10.1158/1055-9965.epi-17-0027
Yerushalmi R, Bargil S, Ber Y, et al. 3,3-Diindolylmethane (DIM): a nutritional intervention and its impact on breast density in healthy BRCA carriers. A prospective clinical trial. Carcinogenesis. 2020;41(10):1395-1401. doi:https://doi.org/10.1093/carcin/bgaa050