Evigrade

Diindolylmethane (DIM)

Indole-3-carbinol metabolite from cruciferous vegetables, supplement. AEMPS does not register as medicine

ATC code: A11JA-DIM

Brand names – supplements: Now DIM, Doctor's Best DIM, Source Naturals DIM, Pure Encapsulations DIMSupplements are not tested in clinical trials and are not registered as medications.

Updated · Methodology

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

D

Acne and PCOS with hyperandrogenism

Not recommended

Diindolylmethane (DIM) is a compound formed from indole-3-carbinol in cruciferous vegetables; it's marketed as a supplement that balances androgen metabolism and so helps with acne and the hyperandrogenism of PCOS. DIM hasn't shown convincing benefit for this use – there's no solid evidence base for acne or PCOS. For acne and hyperandrogenism in PCOS, other approaches have proven results: topical retinoids and azelaic acid, combined oral contraceptives and spironolactone prescribed by a doctor, and weight loss when there's insulin resistance.

ICD-10: L70.0 · ICD-11: ED80

F

Polycystic ovary syndrome

Not recommended

DIM is sold to women with PCOS as a «natural antiandrogen» on the androgen receptor partial blockade hypothesis. No evidence base: no quality RCTs in PCOS patients with testosterone, LH or hirsutism scale (Ferriman-Gallwey) endpoints. 2023 PCOS guideline does not mention DIM. SEGO 2017 lists hormonal contraceptives or metformin first-line for PCOS; for marked androgenic features – spironolactone, cyproterone. If DIM was recommended for PCOS instead of standard therapy and workup, consider seeking a second opinion from a gynaecologist-endocrinologist.

ICD-10: E28.2 · ICD-11: 5A80.1

How to read tiers A–F
  • AStrong evidence – first or second line in international guidelines
  • BRecommended in selected cases
  • CStudy data contradict each other
  • DBenefit not proven, no documented harm
  • FDocumented harm, or risk without benefit

Mechanism of action

Diindolylmethane (DIM) is the main metabolite of indole-3-carbinol formed in acidic stomach environment after cruciferous vegetable intake (broccoli, cauliflower, Brussels sprouts, kale). In the cell DIM modulates oestrogen metabolism via CYP1A1/1A2 induction, shifting the balance between 2-hydroxyestrone (considered «beneficial» metabolite) and 16α-hydroxyestrone (considered «harmful»). DIM is also a weak partial aryl hydrocarbon receptor modulator and androgen receptor blocker in vitro. The «oestrogen balancing» hypothesis is widely exploited in supplement marketing; no quality RCTs with breast cancer, fibroid or endometriosis risk endpoints.

Safety

Contraindications

  • Pregnancy and lactation
  • Children under 18
  • Hormone-sensitive breast or endometrial tumours (theoretical effect on oestrogen metabolism)
  • Tamoxifen or aromatase inhibitor therapy (theoretical interaction)
  • Oestrogen-containing contraceptives (theoretical efficacy reduction via CYP1A2 induction)
  • Warfarin therapy (potential metabolism induction)

Serious adverse effects

  • Reduced efficacy of oestrogen-containing contraceptives
  • Drug interactions with CYP1A2-metabolised drugs (theophylline, clozapine, caffeine)
  • Allergic reactions (rare)

Common adverse effects

  • Nausea
  • Urine colour change (dark yellow or brown)
  • Headache
  • Menstrual cycle changes

Pregnancy: can you take Diindolylmethane (DIM)?

No RCT data in pregnancy. AEMPS does not register. DIM as a high concentration of an active oestrogen metabolism modulator should be avoided in pregnancy.

Breastfeeding: can you take Diindolylmethane (DIM)?

No data on milk transfer. Lactating women should avoid.

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

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Frequently asked

What is Diindolylmethane (DIM) used for?

Diindolylmethane (DIM) is evaluated for the following indications with varying evidence strength: Acne and PCOS with hyperandrogenism (evidence tier D), Polycystic ovary syndrome (evidence tier F). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Diindolylmethane (DIM)?

Common side effects of Diindolylmethane (DIM) (≥ 1 in 100): Nausea, Urine colour change (dark yellow or brown), Headache, Menstrual cycle changes. See the Safety section for uncommon and serious reactions.

Is Diindolylmethane (DIM) safe during pregnancy?

No RCT data in pregnancy. AEMPS does not register. DIM as a high concentration of an active oestrogen metabolism modulator should be avoided in pregnancy.

Is Diindolylmethane (DIM) compatible with breastfeeding?

No data on milk transfer. Lactating women should avoid.

Who should not take Diindolylmethane (DIM)?

Diindolylmethane (DIM) is contraindicated in: Pregnancy and lactation; Children under 18; Hormone-sensitive breast or endometrial tumours (theoretical effect on oestrogen metabolism); Tamoxifen or aromatase inhibitor therapy (theoretical interaction); Oestrogen-containing contraceptives (theoretical efficacy reduction via CYP1A2 induction). Full list in the Safety section.

Other drugs in this group

Epigallocatechin-3-gallate (EGCG, main green tea polyphenol), Elderberry (Sambucus nigra), Eleutherococcus senticosus («Siberian ginseng»), Fisetin (flavonol from strawberries, mangoes and onions), Mucuna pruriens (velvet bean), Pyridoxine (vitamin B6), Thiamine, Bacopa monnieri (brahmi)