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Have you tried DIM for estrogen dominance/hormonal migraine?

As I said in my blogpost about estrogen dominance, there’s 3 forms of estrogen dominance and one of them is linked to impaired detoxification of estrogen in your body...

In order to decompose and detoxify estrogen, our liver needs di-indolyl-methane (DIM). DIM comes from indole-3-carbinol, which is a compound naturally found in cruciferous vegetables such as broccoli, cauliflower, Brussels sprouts, cabbage, etc. When these foods reach the stomach, indole-3-carbinol is broken down by the stomach acid. DIM is then released as a by-product.

Yes, you’re right: you need to eat your cruciferous vegetables!

You can probably imagine that the amount of DIM your body is producing from a serving or two of broccoli isn’t going to be enough if you’re in a state of excess estrogen. You’d need to eat about 6 pounds of these vegetables a day to get a therapeutic dose of DIM. So in order to see results, you need to take DIM in form of supplements. Another thing to consider is that you need to make sufficient stomach acid so that your body can convert the indole-3-carbinol (I3C) from the cruciferous vegetables to DIM and most people are lacking stomach acid. (If you suspect this might be your case, don't hesitate to contact me to discuss how you can improve this).

Let’s look at some benefits of DIM first:

  • it supports healthy estrogen metabolism by supporting phase I liver detoxification

  • it promotes a healthy balance of estrogen and testosterone (aromatase inhibitor)

  • it can help preventing hormone-related cancers due to its anti-estrogenic and anti-androgenic effects

  • it has anti-oxidant effects protecting our cells from oxidation (aka aging)

Is this now THE solution for estrogen dominance? DIM works well for women (and men) of all ages in reducing symptoms of estrogen dominance. However, many women report that it works great for a while and then the symptoms come back or they actually feel worse.

So, what’s going on?

The thing is that DIM is supporting Phase I of your liver detoxification, but complete estrogen metabolism in the body requires support of both Phase I and Phase II liver detoxification pathways. The liver breaks down the fat soluble toxins into smaller components that are more water-soluble, so that they can be eliminated from the body.

If you are using DIM alone, you are increasing the breakdown of toxins and hormones. That’s great, but these broken-down toxins will not be able to get excreted without an active Phase II of liver detoxification - they will actually get recirculated in your body and that’s when it can make you feel worse, because the toxins get recirculated in your body, creating inflammation and more imbalance.

This 2nd phase is crucial to clearing excess estrogens, which are encapsulated and excreted safely out of our body. The main reactions enabling this are called methylation, sulfation, glucuronidation (and glutathione conjugation). Once estrogens are methylated (along with thyroid hormones, environmental toxins, etc), they can be easily excreted. For this, sulfur groups are added to estrogen to facilitate excretion by combining them with sulfur-based compounds, like sulforaphane.

Sulforaphane is an active component of cruciferous vegetables, especially broccoli sprouts. I definitely recommend that you consume these often, but again, to be able to get enough sulforaphane, you might need to opt for a supplement.

The glucuronidation pathway uses glucaric acid to bind toxins, including “spent” estrogens. Glucuronidation is the liver's normal process of attaching a glucuronic acid molecule to potentially harmful substances to detoxify and eliminate them from the body. During phase II liver detoxification, certain hormones and various fat-soluble toxins will undergo glucuronidation and be excreted through the bile or urine.

Calcium-D-Glucarate is calcium bound to D-glucaric acid, which is a natural compound produced in small amounts by the human body and is abundantly found in various plant foods such as broccoli, cabbage, kale, apples, oranges, and grapefruit. Calcium D-Glucarate assists in the detoxification process as it forms conjugates with unwanted estrogenic hormones and environmental toxins, which are then eliminated from the body instead of being reabsorbed.

A supplement called calcium d-glucarate (which is what calcium d-glucarate converts to) helps inhibit the production of an enzyme called beta-glucuronidase, which is produced by certain gut bacteria. (High levels of beta-glucuronidase are associated with breast, prostate, and colon cancers.)

Glutathione, another sulfur-containing molecule, is added to estrogen to facilitate excretion, this process is called glutathione conjugation.

So you need sulfur to support the sulfation pathway, glucaric acid to support the glucuronidation pathway and glutathione to support the glutathione conjugation. These are all chemicals that our body is producing from the nutrients that we ingest. For proper function, our liver requires the following nutrients: methionine, cysteine, glutathione, magnesium, vitamin C, choline, folate glutamine, and sulfur containing foods. As I said above, if you are in a state of excess estrogen, what you are able to take in via food is most likely not enough. Opting for a supplement that contains DIM, broccoli extract or sulforaphane and calcium d-glucarate is a complete formula to support your estrogen metabolism.

If you are having thyroid issues, you might be confused now: aren’t you supposed to avoid goitrongenic aka cruciferous vegetables?

The answer is yes and no: while they might impact your thyroid hormone production, you also see how important they are for estrogen detox and that again will have a positive impact on your thyroid!

In this study involving the University of California, researchers concluded that though collard greens, Brussels sprouts, and some Russian kale (Brassica napus) contain enough goitrogenic compounds to potentially decrease iodine uptake, that’s not true for all cruciferous vegetables. The researchers found that turnip tops, broccoli, broccoli rabe, and kale contain less than 10 μmol of goitrogenic chemicals per serving of 100g, concluding that those foods can be considered minimal risk. And that is even further minimized by consuming these foods cooked rather than raw. There is no evidence that cruciferous vegetables slow down your thyroid function. In fact, cruciferous vegetables are super nutritionally dense foods so they are good for women with thyroid issues who are often depleted in micronutrients.

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