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Supplements

Diindolylmethane (DIM)

What Is It?
Health Benefits
Dosage Information
Forms
Guidelines for Use
General Interaction

Possible Side Effects

Cautions

References

Evidence Based Rating Scale
 

What Is It?

Diindolylmethane (DIM) is a plant compound derived from digesting indole-3-carbinol, which is found in cruciferous vegetables such as broccoli, Brussels sprouts, cabbage and cauliflower. It promotes beneficial estrogen metabolism in women and men, thereby working to balance hormone levels. It also detoxifies the intestines and liver and supports a healthy immune system. Researchers believe indole-3-carbinol, and thus DIM, also might be one of the cancer-protective agents found in the cruciferous vegetables. (1, 2) 

Indole-3-carbinol is produced when the vegetables are cut or chewed but is inactive until it comes into contact with stomach acid, causing it to be converted to the active metabolite DIM. Researchers are interested in this for potential cancer-protective properties against breast, cervical, endometrial, and colorectal cancers. For this reason, the National Cancer Institute has reviewed the use of DIM for preventing several forms of cancer and is now sponsoring clinical research for breast cancer prevention. (3) Diindolylmethane also is being researched as a potential treatment for a variety of viral infections and anti-biotic resistant bacteria. 

Health Benefits 

Diindolylmethane seems to have several effects on estrogen and the metabolism of toxins in the liver. Because it induces a compound that alters estrogen metabolism, DIM may be helpful in protecting against hormone-dependent cancers such as breast cancer. Some evidence also suggests DIM may have other protective effects as an antioxidant. (4, 5) It is used to treat fibromyalgia, laryngeal papillomatosis, cervical dysplasia, premenstrual syndrome (PMS) and systemic lupus erythematosus, as well as to balance hormone levels, detoxify the intestines and liver, and to support the immune system. 

Specifically, DIM may help: 

  • Prevent breast cancer and cervical cancer. Ingestion of indole-3-carbinol, and thus the production of DIM, alters estrogen metabolism of estradiol, a sex hormone that has a critical impact on reproductive and sexual functioning. Estradiol normally is metabolized into compounds that are thought to increase the risk of breast and cervical cancers. However, the DIM causes estradiol to be metabolized to a weaker estrogen and more benign compound, possibly producing a protective effect against these hormone-related cancers. (6-11) Several in vitro studies and studies on rodents have found potential activity against breast cancer cells by inhibiting tumor growth and inducing apoptosis (programmed cell death) in human breast cancer. (12-16). However, conflicting evidence exists, and more research is needed to confirm the role of DIM in preventing cancers in humans.  

  • Cervical dysplasia. In patients with mild (or early precancerous stages of) cervical dysplasia (CIN), synthetic and natural forms of indol-3-carbinol have been shown to prevent further development of the invasive disease of the cervix. In a 2000 placebo-controlled study of 30 women with stage II-III CIN, treatment of 200 mg or 400 mg of indole-3-carbinol daily for 12 weeks seemed to cause complete regression of CIN. The lower dose seemed to be just as effective as the higher dose. (17)  

  • Respiratory papillomatosis. Some preliminary clinical evidence indicates that long-term use of indole-3-carbinol might reduce papilloma growth in patients with recurrent respiratory papillomatosis. In a 2000 placebo-controlled study of 18 patients treated with oral indole-3-carbinol for eight months or longer, six patients (33 percent) reported cessation of papilloma growth and did not require surgery, another six patients reported a reduced growth rate, and the remaining six patients showed no clinical response to the compound. Researchers concluded that indole-3-carbinol appears to be safe and well tolerated and may be an efficacious treatment for recurrent respiratory papillomatosis. However, a blind, controlled trial was recommended. (18) A 2007 review of studies found that small preliminary trials in humans suggest supplementation may be beneficial in treating conditions related to human papilloma virus infection, such as recurrent respiratory papillomatosis, but larger randomized controlled trials are needed. (19) 

    Forms        

  • capsule        
  • food 

    Dosage Information 

    The typical diet supplies 20 to 120 mg of indole-3-carbinol per day (one head of cabbage contains about 1200 mg). About 10 to 20 percent of the typical intake of indole-3-carbinol is converted to diindolylmethane, providing 2 to 24 mg daily. 

    Current evidence does not support recommendations for dosages for DIM at this time. DIM in a patented oral delivery system (U.S. patent #6,086,915) is available in 75 to 150 mgm capsules containing @ 25% DIM .  

     Guidelines for Use 

    Diindolylmethane is not easily absorbed. Taking some forms of vitamin E enhances the absorption of DIM. The patented form of DIM is being used in the current clinical trials. Consult your doctor or licensed nutritional counselor before taking supplements containing these nutrients. 

    General Interaction 

    There are no known drug or nutrient interactions associated with DIM. 

    Possible Side Effects 

    There are no known side effects associated with DIM. 

    Cautions 

    If you are pregnant or lactating, the amount of DIM typically consumed in foods is likely to be safe. However, insufficient evidence exists regarding amounts greater than those found in foods, so you should avoid consuming more DIM than what you get from your normal diet during pregnancy and breastfeeding. 

    References 

    1. Riby JE, Chang GHF, Firestone GL, Bjeldanes LF. Ligand-independent activation of estrogen receptor function by 3,3’-diindolylmethane in human breast cancer cells. Biochem Pharmacol. 2000;60:167-77.

    2. Ge X, Yanni S, Rennert G, et al. 3’3-diindolylmethane induces apoptosis in human cancer cells. Biochem Biophys Res Commun. 1996;228:153-8.

    3. Natl Inst Health, Natl Inst Environmental Health Sci. Indole-3-carbinol. Available at: http://ntp-server.niehs.nih.gov.

    4. Telang NT, Katdare M, Bradlow HL, et al. Inhibition of proliferation and modulation of estradioil metabolism: novel mechanisms for breast cancer prevention by the phytochemical indole-3-carbinol. Proc Soc Exp Biol Med. 1997;216:246-52.

    5. Bradlow HL, Sepkovic DW, Telang NT, Osborne MP. Multifunctional aspects of the action of indole-3-carbinol as an antitumor agent. Ann NY Acad Sci. 1999;889:204-13.

    6. Michnovicz JJ. Increased estrogen 2-hydroxylation in obese women using oral indole-3-carbinol. Int J Obes Relat Metab Disord. 1998;22:227-9.

    7. Michnovicz JJ, Bradlow HL. Induction of estradiol metabolism by dietary indole-3-carbinol in humans. J Natl Cancer Inst. 1990;82:947-9.

    8. Bradlow HL, Michnovicz J, Telang NT, Osborne MP. Effects of dietary indole-3-carbinol on estradiol metabolism and spontaneous mammary tumors in mice. Carcinogenesis. 1991;12:1571-4.

    9. Grubbs CJ, Steele VE, Casebolt T, et al. Chemoprevention of chemically-induced mammary carcinogenesis by indole-3-carbinol. Anticancer Res. 1995;15:709-16.

    10. Kojima T, Tanaka T, Mori H. Chemopreventive of spontaneous endometrial cancer in female Donryu rats by dietary indole-3-carbinol. Cancer Res. 1994;54:1446-9.

    11. Yuan F, Chen DZ, Liu K, et al. Anti-estrogenic activities of indole-3-carbinol in cervical cells: implication for prevention of cervical cancer. Anticancer Res. 1999;19:1673-80.

    12. Riby JE, Chang GHF, Firestone GL, Bjeldanes LF. Ligand-independent activation of estrogen receptor function by 3’3-diindolylmethane in human breast cancer cells. Biochem Pharmacol. 2000;60:167-77.

    13. McDougal A, Gupta MS, Ramamoorthy K, et al. Inhibition of carcinogen-induced rat mammary tumor growth and other estrogen-dependent responses by symmetrical dihalo-substituted analogs of diindolylmethane. Cancer Lett. 2000;151:168-79.

    14. Chen I, McDougal A, Wang F, Safe S. Aryl hydrocarbon receptor-mediated antiestrogenic and antitumorigenic activity of diindolylmethane. Carcinogenesis. 1998 Sep;19:1631-9.

    15. Ge X, Yanni S, Rennert G, et al. 3’3-diindolylmethane induces apoptosis in human cancer cells. Biochem Biophys Res Commun. 1996;228:153-8.

    16. Chen I, Safe S, Bjeldanes L. Indole-3-carbinol and diindolylmethane as aryl hydrocarbon (Ah) receptor agonists and antagonists in T47D human breast cancer cells. Biochem Pharmacol. 1996;51:1069-76.

    17. Bell MC, Crowley-Nowick P, Bradlow HL, et al. Placebo-controlled trial of indole-3-carbinol in the treatment of CIN. Gynecol Oncol. 2000;78:123-9.

    18. Rosen CA, Woodson GE, Thompson JW, et al. Preliminary results of the use of indole-3-carbinol for recurrent respiratory papillomatosis. Otolaryngol Head Neck Surg. 1998 Jun;118(6):810-5.

    19. Higdon JV, Delage B, Williams DE, Dashwood RH. Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res. 2007 Mar;55(3):224-36.

    Evidence Based Rating Scale 

    The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements and therapies demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.

    Condition

    Rating

    Explanation

     

     

      

     

     

     

      

    Cancer prevention

     

     

     

      

     

     

     

     

     

     

     

    Several in vitro and animal trials indicate efficacy, but inconsistent evidence also exists. More research is needed to confirm efficacy in humans.

     

     

     

      

     

    Cervical dysplasia

     

     

     

      

     

     

    Preliminary studies indicate efficacy. More research is needed to confirm initial findings.

     

     

     

     

     

     Respiratory papillomatosis

     

     

     

      

     

    Date Published: 10/30/2007

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