Q. What is DIM, and how can it help hormones?
A. DIM is a phytonutrient (plant
nutrient) found in cruciferous vegetables. These include cabbage,
broccoli, bok choy, Brussels sprouts, cauliflower, kale, kohlrabi,
mustard, rutabaga, and turnip. These plants have been cultivated for
thousands of years and were initially used for their medicinal
benefits. The connection between DIM and hormones like estrogen has to
do with similar characteristics between them at the molecular level.
DIM is not an estrogen or a hormone, but like estrogen it shares the
common characteristic of being poorly soluble in water. Like estrogen,
DIM can be metabolized only by a special class of cytochrome enzymes
that reside in cell membranes in the non-water part of cells. It turns
out that DIM, when consumed in food or in absorbable formulations,
encourages its own metabolism. This special metabolic pathway for DIM,
and the enzymes involved, precisely overlap with the pathway needed for
healthy estrogen metabolism.
Stated simply, supplementing the diet
with DIM specifically promotes beneficial estrogen metabolism and helps
restore a healthy hormonal balance.
Q. What is estrogen dominance?
A. Middle-aged men and women experience
changes in hormone production and metabolism resulting in excess
estrogen action. There are three basic forms of this common imbalance
known as estrogen dominance.
Perimenopause. In women,
slower hormone metabolism in midlife can mean higher-than-normal levels
of estrogen and a deficiency in its healthy metabolites. Faltering
estrogen metabolism often occurs in women during perimenopause, the
years before menopause, and is characterized by higher monthly estrogen
levels prior to estrogen's dramatic fall at menopause.(2) Additionally,
progesterone levels fall during perimenopause, resulting in a rising
estrogen-to-progesterone ratio.
Middle-aged men. Rising
estrogen also becomes a problem for men during their 50s and 60s. In
overweight men, testosterone is increasingly converted into estrogen by
aromatase and rising estrogen also competes with falling testosterone.
This corresponds to a time during which estrogen accumulates in the
prostate gland. Estrogen is believed to contribute to benign prostatic
hypertrophy (BPH).(3)
Acquired estrogen imbalance.
This important form of estrogen dominance has to do with inherited
problems in estrogen metabolism and influences of diet and chemicals on
beneficial metabolite production. Acquired estrogen imbalance affects
both men and women. Almost 20 years ago, H. Leon Bradlow, Ph.D., a
renowned breast cancer investigator, discovered women with breast and
uterine cancer made too little of the 2-hydroxy or "good" metabolite of
estrogen and too much of the 16-hydroxy or "bad" variety.(4)
Since 16-hydroxy is an unregulated form
of estrogen prone to behave like "super-estrogen," higher levels create
a particularly unhealthy form of estrogen dominance. 16-hydroxy
estrogens can result in mutations, abnormal growth (as in cervical
dysplasia),(5) and an increased risk of future breast cancer.(6)
Overproduction of 16hydroxy estrogen is also seen in obesity,(7)
high-fat diets,(8) and exposure to a host of "estrogenic" environmental
chemicals.(9) Therefore, this dangerous form of estrogen dominance can
result from inheritance, diet, and environmental chemicals.
Q. What benefits can DIM offer?
A. Supplementing our diets with DIM can
shift the production of estrogen metabolites away from dangerous
16-hydroxy in favor of beneficial 2-hydroxy metabolites. Taking DIM
in an absorbable formulation encourages active and healthy estrogen
metabolism. DIM supports estrogen balance by increasing beneficial
2-hydroxy estrogens and reducing the unwanted 16-hydroxy variety. This
improves estrogen metabolism and helps resolve all three forms of
estrogen dominance.
Note: Remember, 2-hydroxy is
good; 16-hydroxy is bad.
Q. Why not just eat more cruciferous vegetables?
A. Recent reports, like one from the
Fred Hutchison Cancer Center in Seattle, Washington indicate a
higher intake of cruciferous vegetables is associated with a lower risk
of prostate cancer.
This study indicates cruciferous
vegetables are protective for hormone-sensitive cancers. However,
direct measurements of upward, beneficial shifts in estrogen metabolism
indicate you would have to eat at least two pounds per day of raw or
lightly cooked cruciferous vegetables to derive the same benefit as two
capsules of specially formulated DIM. Benefits for cervical dysplasia,
PMS, BPH, and other conditions have not been seen with the use of
broccoli, cabbage juice, or dried powders or extracts from vegetables.
Absorbable DIM formulations overcome the
need for active enzymes within the vegetable and chemical reactions in
your stomach to produce DIM. For similar reasons, absorbable DIM
provides many advantages over indole-3carbinol (I3C), another
cruciferous phytochemical available as a supplement. I3C is an unstable
precursor that requires activation in the stomach to be converted into
DIM. This means I3C must be taken at a much higher dose and can undergo
unpredictable and undesirable chemical reactions in your stomach and
colon. DIM, in a delivery system to assure absorption, is by far
preferable to the supplemental use of I3C.
Q. How much DIM is recommended?
A. To replace the DIM from healthy
amounts of cruciferous vegetables in the diet, women should take a
starting dose of about 15 mg per day of actual DIM in an absorbable
formulation. Men should take about 30 mg per day of actual DIM in
the same absorbable formulation. These amounts can be
increased three to four times on an individual basis to derive needed
benefits for hormonal balance and metabolism. Based on testing in men,
improved estrogen metabolism, easier weight loss, and prostate health
require a higher dose of DIM than in women.
Since pure DIM must be provided in an
absorption-enhancing formulation, the dose for DIM sometimes specifies
the weight of the absorbable formulation, which is only one-fourth, or
25 percent DIM. In the book, All About DIM, the suggested dose
of 100 to 200 mg per day for women and 200 to 400 mg of DIM per day for
men refers to milligrams of such an absorbable formulation.(15) This
dose range for hormonal balance corresponds to 25 to 50 mg per day of
actual DIM for women and 50 to 100 mg of actual DIM for men.
Q. What’s exciting about the effect of DIM on
premenstrual syndrome (PMS)?
A. PMS symptoms of irritability,
aggression, tension, depression, mood swings, water retention, and
breast pain or swelling are frequently seen in perimenopausal
women.(16) While a reduction in PMS severity has been seen with
nutritional therapy, full resolution has been elusive. These
interventions have included lower-fat diets,(17) and supplementation
with minerals, Vitamin D,(18) and herbal extracts.(19)
PMS symptom improvement has been noted
after beginning dietary supplementation with absorbable DIM. These
results suggest DIM is able to correct the estrogen imbalance in PMS.
Torbjorn Backstrom, M.D., an eminent researcher in the field (20), and
others (21) have documented that estradiol, the primary active form of
estrogen, is elevated in PMS. Backstrom also has shown the degree of
estradiol elevation correlates with symptom severity.(22)
Also encouraging is the observation that
the enzyme pathways promoted by DIM help metabolize pregnenolone
sulfate.(23) Pregnenolone sulfate is a brain hormone important for
memory, but which causes anxiety if levels are too high. Like estrogen,
pregnenolone sulfate is elevated in PMS.(24) Its healthy metabolism
produces beneficial, immune stimulating metabolites and may help relieve
anxiety. Absorbable DIM supplementation promotes healthier
metabolism of both estrogen and pregnenolone in PMS.
Q. What's the best supplementation approach to
PMS?
A. A strong nutritional approach to PMS
includes bio-available DIM, chaste berry extract, Vitamin D, calcium,
and magnesium. Synergistic interaction of these ingredients benefits
PMS. An example of this synergy is the ability of beneficial 2-hydroxy
estrogens to increase progesterone production (25), potentiating this
effect by chasteberry extract.(26) This new nutritional approach to PMS
helps with mineral and hormonal balance. DIM works in conjunction
with chasteberry extract to resolve the dominance of estrogen over
progesterone.
Q. How can helping estrogen metabolism benefit
men?
A. Everyone knows estrogen is an
important hormone for reproduction in women. What is not often
appreciated is that estrogen levels, though lower than those in women,
are also essential in men. However, midlife changes in men result in
excess estrogen production beyond its minimal essential level.
Like perimenopausal women, men
experience a tendency to gain weight in midlife. Rising estrogen
production can result, since fat cells contain the aromatase enzyme that
converts testosterone into estrogen. Unmetabolized estrogen creates a
vicious cycle resulting in further estrogen production. This occurs
because fat is one source of more active aromatase enzymes, causing
further estrogen production and continuing weight gain.(27) An open
label study of DIM in overweight men and women showed it promoted
more efficient weight loss and more active fat metabolism.
In this regard, DIM is similar to green
tea extract (28) and spices like cayenne pepper.(29) DiindolyImethane
may have a role in helping to intervene with excess estrogen production
associated with obesity and male aging. Besides weight
gain, another aspect of early aging in men is prostate gland
enlargement.
It has been clearly established that
estrogen accumulates in aging prostate glands at the same time
enlargement occurs.(30) This process is linked to difficulty with
urination and frequent urination at night. The role of estrogen is
still being established in this process, but research using estrogen
binding substances shows lowering estrogen levels improves the symptoms
of nighttime urination.(31) Use of absorbable DIM by men with these
same symptoms has proven beneficial.
Q. Can DIM help improve the safety of hormone
replacement therapy (HRT)?
A. Despite a growing list of benefits
attributed to estrogen, which include younger-looking skin, more
comfortable sex, and better memory, women often view its potential side
effects as unacceptable. Study of postmenopausal women receiving
long-term HRT with estrogen and estrogen/progesterone combinations has
revealed an unequivocal increase in breast cancer risk.(32)
NaturoDoc Note: These studies were done
with Premarin, horse estrogens, and synthetic progestins, NOT
progesterone.
Added concerns relate to the increase in
the incidence of uterine cancer, and increased risk of life-threatening
blood clots, especially after bone fracture.(33) Most recently, the
nationwide HERS study reported the concerning finding that women with a
history of heart disease had an increased risk of heart attack in the
first year after starting estrogen.(34)
Many of estrogen's risks can be related
to a lack of its beneficial metabolites. It is now known that a lower
risk of future breast cancer is associated with higher 2-hydroxy
estrogen levels. Supplementation with Nutrition 2000's DIM increases
protective 2-hydroxy estrogen and therefore may reduce the risk of HRT-related
cancer. Reduction in the risk of abnormal blood clot formation related
to HRT estrogen would benefit women who suffer fractures while on HRT,
but also may benefit women with early heart disease. It has been known
since the Framingham Study in Massachusetts that men with the highest
estradiol level had the highest risk of early heart attack.(35) DIM may
help normalize the cardiac risk in both men and women related to
unhealthy or underactive estrogen metabolism. Also, the beneficial
2-hydroxy metabolites have been shown to be powerful antioxidants,(36)
which may contribute to protecting against the early stages of
atherosclerosis and subsequent heart attacks.
