DIM (diindolylmethane) is a fantastic nutritional supplement I use in clinical practice due to its documented therapeutic results. Why do I love it so much? Prevention of certain cancers such as prostate, breast and endometrial – hormone balancing, estrogen dominance relief, reduces PMS and menopausal symptoms  genetic and epigenetic modifications, and of course endometriosis. 

Our digestive system makes small amounts of DIM from I3C but I have found that it may be better to supplement with it instead. You could also eat copious amounts of cruciferous vegetables… (for the indole – 3 – carbinol or I3C compound) but I don’t recommend anyone do this.

You have been hearing me speak more and more about pathways within the body, from detox pathways to enzymatic pathways. DIM is known to adjust the enzymatic pathways of estrogen hydroxylation, and also aromatization. That’s not all of course, when we look at the research being done on our DNA we can see that DIM is being shown to reduce the growth of certain cancer cells as well as epigenetic modification of specific DNA promoters areas. 

OK let’s get geeky for a second…. CYP3a4 is a phase 1 hydroxylation enzyme that metabolizes around 60% of various substances passing through the liver. Remember how I am constantly talking about cleaning up and supporting the liver? Are you starting to see why? It has a pretty heavy job. The liver is often an over looked part of hormonal metabolism. All steroid hormones (cortisol, estrogen etc.) are converted and metabolized into different forms by the liver. CYP3a4 is one of the most important phase 1 enzymes for that very reason. It hydroxylates E2 (estradiol) and E1 (estrone), into 16aOHE1 and 16aOHE2. These are some pretty controversial estrogens since they posses some hefty anabolic actions on cells. There are a number of pharmaceuticals that are also metabolized via CYP3a4 as well as environmental chemicals such as xenoestrogens, BPA, phthalates and xenobiotics. 

You may want to think about adding DIM to your supplement regime along with antioxidant support to try to limit these nasty chemicals. 

A few of my go to additions are:

• micellized vitamin A (if you have gut or thyroid issues this is a must)
• whole food vitamin C
• selenium + myo-inositol
• Curcumin
• N-acetylcysteine (NAC)-fantastic for liver support
• polyphenols, I get mine from high polyphenol count olive oil
• S- acetyl Glutathione is also something to look into

So how can DIM help? It is a moderate inhibitor of CYP3a4 which means it has the ability to reduce the production of 16aOHE1 and 16aOHE2. This is a good thing.

The basic gist of it is that those who are suffering estrogen dominance, and that number is on the rise, will benefit from the effects of DIM on the estrogen detox pathways (I like to recommend 200 – 300 mg per day).

Other supplements to look into are:

Kudzu for its phytoestrogenic effects

SGS or Sulforaphane Glucosinolate to help support phase 2 detox. The phase 2 pathway is the final stage for the removal of harmful compounds, detoxification products and excess estrogens. It’s relatively easy to stimulate phase 1 detoxification (done by many herbs and B-vitamins) but much it is more difficult to activate the phase 2 pathway. This pathway is essential for the elimination of excess hormones (i.e. estrogen) which cause symptoms of hormonal imbalance (i.e. menopause, bloating, mood, weight gain, acne etc.).   Personally I just eat a ton of broccoli sprouts since this is where the compound is found in it’s highest potency. 

B vitamins – you want to be sure you don’t have any MTHFR gene mutations so you know which type to supplement with, I always recommend a solid DNA panel. These are necessary for phase 1 detox along with a slew of other areas of the body that utilize them.

Have you tested your DNA (and I don’t mean the gimmicky 23andme crap),  have you run a thorough hormone panel? Did you doctor tell you this is all a normal part of aging and you are fine? Maybe it’s “all in your head” . Perhaps it’s time you brought a little functional medicine into your life.

Holly Warner is a Board Certified Practitioner who specializes in clinical nutrition with a background in functional medicine. As a clinician she is able to run diagnostics which get to the root cause of what’s really going on with your health. From hormone imbalances, thyroid issues, gut health, adrenal dysfunction, metabolic syndrome, DNA and autoimmune disease. Her approach is based on science and combined with a holistic root cause perspective.