I have long been an advocate of the supplement DIM, you will find many articles about it on this website. DIM is short for di-indolyl-methane and it is made from plant indoles, natural phytonutrients found aplenty in cruciferous vegetables like kale, cabbage, brussel sprouts, spinach, and my favorite, broccoli. Indoles help to manage out-of-control estrogen and estriol levels in both men and women. Today I’m sharing some information about one of the possible side effects of DIM supplementation. Your urine might change color when taking DIM. It can be a surprise if you’re not expecting it, and even slightly worrisome.
While I was on the subject I took a look at all of the newest (and exciting) research on DIM and have included that information in this article as well.
About That Urine Color Change with DIM…
I have taken DIM myself on many occasions. Recently, however, I changed my DIM product to a stronger formulation and began to notice something rather odd. My urine was a dark orange, almost a bronzey red color. I have NEVER seen my urine that color before and I began to worry that I had a bladder infection or a UTI.
I almost went in for a urinalysis, but then did a quick Internet search and connected the two. DOH! These are common symptoms when taking DIM. So I stopped taking it for a day or two and the dark urine color changed back to normal. I wondered why it hadn’t happened to me before because as I say, I have taken DIM before. But then I recalled that I was taking a stronger and better formulation.
So Why Does Your Urine Change Color When You Take DIM?
Because DIM is doing great things for you! It can be a sign that it is assisting your liver to detox your body of excess estrogen metabolites and other environmental estrogens (known as xenoestrogens). For that reason, it’s a good idea to also take some sort of liver support while taking DIM supplements. The herb milk thistle is extremely good for this. Also drinking lots of green tea is helpful for liver support. Please also ensure you drink lots of filtered water when you’re taking DIM because your body is trying to excrete toxic substances and you need to help it flush them out of your body. Add a slice of lemon and get some vitamin C too!
There are times when a change of urine color should be checked out by your doctor – see Other Causes for Concern for Dark Urine, below.
New Research on DIM
I’m excited to share some new research on DIM, just released.
But firstly, an older study on mice reported in 2008 by American researchers found that DIM had anti-viral properties and immunomodulatory function – this means that when the immune system is too low, DIM will boost it, and when it is over-reacting, DIM will help to quiet it down. 
Research published in October 2016 by Korean researchers examining the effect of DIM on mice with colitis found that DIM has anti-inflammatory properties (always a good thing for your anti-cancer arsenal). It also suppresses the expression of vascular endothelial growth factor, a growth factor associated with a tumor’s ability to create new blood vessels to feed itself, a process called angiogenesis. 
Chinese research published in September 2016 investigating the effects of DIM on mice undergoing total body radiation found that DIM has radioprotective properties . This is great news. These researchers also found that DIM helps to offset the injury that occurs to hematopoiesis, our ability to create new blood cells. This is one of the reasons people can have alarming decreases in various blood cell types when undergoing radiation.
Joint USA/Chinese research reported in September 2016 (again on mice) found that DIM reduces prostate tumor growth by suppressing a gene known as PCGEM1, while promoting apoptosis. 
A joint USA/Indian study on animals released in August 2016 found that two compounds in DIM (DIM-10 and DIM-14) possessed strong anti-cancer effects, and were responsible for a significant reduction in tumor size in triple negative breast cancer cells.  These are cells that are not affected by hormones or HER2 status. An older 2002 study also found that DIM could induce apoptosis in breast cancer cells independent of estrogen receptor status. 
A July 2016 Korean study indicated DIM could also be useful for gastrointestinal cancers. 
A 2014 Canadian study investigated the ability of DIM to upregulate BRCA1 expression. Upregulating this breast cancer suppressor gene translates to a reduced breast cancer risk. Although a small study, the women receiving 300 mg per day (150 mg twice per day) of DIM experienced a 34% increase in BRCA1 expression.  Very encouraging for those carrying the BRCA1 mutation.
For those of you whose breast tumors are/were HER2 positive, DIM can help here too. A 2013 study found that DIM enhanced the anti-tumor activity of Herceptin, a targeted drug designed specifically for those whose breast cancer tumors overexpress the HER2 oncogene HER2. 
One other interesting thing. When taking DIM, oxygen levels in tumor cells increase. This is a really great thing because oxygen is hated by cancer cells. They thrive in anaerobic conditions (meaning without oxygen) so something natural that increases cellular oxygen levels is beneficial. The study was done at the University of California at Berkeley in 2008 and it was the first to demonstrate that DIM works by decreasing the accumulation and activity a key factor involved in angiogenesis called HIF-1alpha in hypoxic cancer cells. 
If your urine turns dark when taking DIM, do not be alarmed. There are times, however, when you do need to be concerned and watchful for other symptoms. If your liver is diseased, you may have symptoms such as yellowing of eyes and skin, abdominal pain, pale or red stool, itchy skin, nausea and loss of appetite. Kidney disease symptoms include loss of appetite, fatigue, problems sleeping, muscles cramping and twitching, and decreased urine output.
 3,3′-Diindolylmethane Stimulates Murine Immune Function In Vitro and In Vivo – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2387240/
 Effect of Oral Administration of 3,3′-Diindolylmethane on Dextran Sodium Sulfate-Induced Acute Colitis in Mice – https://www.ncbi.nlm.nih.gov/pubmed/27700072
 3,3′-diindolylmethane Mitigates Total Body Irradiation-induced Hematopoietic Injury in Mice – https://www.ncbi.nlm.nih.gov/pubmed/27609226
 Regulation of PCGEM1 by P54/NRB in Prostate Cancer – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5041109/
 Novel Diindolylmethane Derivatives Based NLC Formulations to Improve the Oral Bioavailability and Anticancer Effects in Triple Negative Breast Cancer – https://www.ncbi.nlm.nih.gov/pubmed/27586082
 Bcl-2 Family-mediated Apoptotic Effects of 3,3′-Diindolylmethane (DIM) in Human Breast Cancer Cells – https://www.ncbi.nlm.nih.gov/pubmed/11931841
 Cellular and Molecular Mechanisms of 3,3′-Diindolylmethane in Gastrointestinal Cancer – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964527/
 BRCA1 mRNA Levels Following a 4–6-week Intervention with Oral 3,3′-diindolylmethane –
 3,3′-Diindolylmethane Reduces Levels of HIF-1a and HIF-1 Activity in Hypoxic Cultured Human Cancer Cells – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2387239/
 3, 3′-diindolylmethane Enhances the Effectiveness of Herceptin against HER-2/Neu-Expressing Breast Cancer Cells – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551844/
GET MY BEST TIPS on getting through breast cancer and preventing recurrences by signing up for my free e-newsletters and e-books on the right. You can also “like” me on Facebook (Marnie Clark, Breast Health Coach) to get my inspirational snippets, news and updates. I promise to do my utmost to keep you informed and empowered on your healing journey… and beyond.
Photo courtesy of freedigitalphotos.net and M Bartosch
Clarification On DIM And Its Uses For Breast Cancer
Back to work! I’ve been moving from Colorado to Australia, hence the very quiet period on the website. Just before leaving, I had the opportunity to get some clarification on DIM and its uses for breast cancer from Naturopath Dr Jacob Schor, whose views on various health matters have appeared on this blog previously, most notably in these two articles:
I was quite upset when I wrote that first article, but I am letting it stay on this site in the event that other women are given the same information about DIM – that it acted like Tamoxifen. That does not appear to be the case, but it does have some therapeutic value for breast cancer. Read on.
Once you’ve read the above two articles, and the lengthy article that Dr Schor wrote about estrogen metabolite ratios, you’ll understand better what the issue is with regard to DIM and the old theory of how it supposedly worked.
Basically, natural health care providers have been – for years – recommending the supplement DIM for their patients who have estrogen receptor positive breast cancer but they have been basing their recommendations on a theory that just hasn’t been proven to be true.
Wait! Don’t Throw The DIM Out Yet!
Dr Schor, in a recent email to me, shared with me the following: “That theory is used to justify DIM use but we shouldn’t mix the two up. Just because the theory doesn’t work doesn’t mean that DIM doesn’t work. Because it seemed to lock in to the theory, all benefits were thought to come from its effect on estrogen metabolites. I’m not sure that is so but I am also not sure we should throw DIM in the trash. I think we need to think twice about testing 2 vs 16 metabolite ratios, that we should not think these lab tests are prognostic and we should not be in a rush to move them one way or another.
There seem to be a surplus of interesting papers being published that suggests that DIM does things we want it to do. There are a growing number of reasons to take it. There are fewer and fewer reasons to think the 2/16 hydroxy estrogen theory is the reason why it is useful.“
Dr Schor referred me to the following very interesting articles:
BreastDefend™ is a product that is readily available in the USA but I’m not aware of it being available in Australia or the UK yet.
Dr Schor advises us: “So don’t throw out the DIM, throw out the reasons why people thought it was good. It’s not tamoxifen. It’s not an aromatase inhibitor. It’s something else.”
Dr Schor’s qualifications are Naturopathic Doctor, Fellow American Board of Naturopathic Oncology, Associate Editor, The Natural Medicine Journal, Board Member and President, Oncology Association of Naturopathic Physicians (www.OncANP.org) and Board Member of the American Association of Naturopathic Physicians (www.naturopathic.org)
If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters and e-book on the right, or “like” me on Facebook (MarnieClark.com). It is my honor and my goal to help you through this so that you emerge from breast cancer feeling better than before, thriving!
Dr Schor is a gifted naturopath in Denver, and is also President of the Oncology Association of Naturopathic Physicians. Fair warning – the article is not an easy one to read – I suggest you print it out and go put your feet up in a quiet place to digest the information. It will probably require several readings to fully appreciate what Dr Schor is telling us about estrogen metabolite ratios.
I found the information fairly depressing, because I (and many like me) had been relying on DIM to keep circulating estrogen levels at a safe range without having to resort to the toxicity of Tamoxifen. Having said that, I really appreciated Dr Schor’s review of the research, and his courage to publish an article that goes against the current thinking. We need more fine minds like his in this fight.
If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters on the right, or “like” me on Facebook (Marnie Clark, Breast Health Coach). It is my honor and my goal to help you through this.
Photo courtesy of freedigitalphotos.net and healingdr
DIM – A Misunderstood Natural Supplement
A chance message from one of the members at a breast cancer forum of which I am also a member (breastcancer.org) had me scurrying around yesterday, in an attempt to discover some information about a favorite supplement of mine named DIM, also known as di-indolyl-methane, hence the easier moniker DIM.
She had heard that taking DIM might raise progesterone levels and since her tumor was progesterone receptor positive (as was mine), this was a concern. So she asked me about it and I referred the question to the naturopath whose opinion I most highly respect, Dr Jacob Schor, my mother’s naturopath in Denver, who is the President of the Oncology Association of Naturopathic Oncology and also Associate Editor of The Natural Medicine Journal (and, among other things, a very learned man and someone I trust).
Too Good to be True?
DIM is a supplement I had been taking myself for about 4 years – it was recommended to me by a naturopath in Australia because it supposedly promotes beneficial estrogen metabolism and healthy hormonal balance and was supposed to be especially helpful for managing estrogen dominant conditions. Even though my tumor was not fueled by estrogen, he felt it would still have benefits for me. Some articles I found on the Internet even said it was better than Tamoxifen, a well-known breast cancer drug.
DIM and Estrogen Metabolites
Apparently the longer view, taken from more current and exhaustive research, however, is that DIM is not in any way a replacement for Tamoxifen, nor does it work in the manner initially thought.
Dr Schor shared with me a soon-to-be-released article he’d written on the subject of estrogen metabolite ratios for The Townsend Letter, an alternative medicine journal, but asked me merely to ingest its contents and not forward it on as it had not been released yet.
The contents of the article had my head spinning. After reviewing decades of research on estrogen metabolites, Dr Schor feels that we have been going on a theory that just has not proven to be fact, no matter how much we might wish it to be true. He told me in an email yesterday, “there is certainly little reason to think that DIM was a substitute for Tamoxifen, there was nothing about the proposed mechanism of action that was similar. One could argue that at least flax seed or soy genestein was kind of similar in action. Sorry to be the party pooper.”
He did say that DIM has some great health benefits and he still recommends it. It just doesn’t work the way we thought it did.
IMPORTANT UPDATE: 31 October 2013 – Rather than delete this page, because a few other websites and articles link to it, in an effort to keep you updated with all the relevant studies and thinking on the issue of DIM, here are links to two more of my articles on this subject, which will definitely help you to realize that DIM does have some very good healing properties, and that you SHOULD be using it for breast health, just not for the reasons we initially thought.
And here is a link to another relevant website, Life Over Cancer, on the subject of DIM written by Dr Keith Block: DIM and Breast Cancer
My own thoughts and feelings are that the best thing we can do for ourselves to keep ourselves disease free are relatively simple. Follow the recommendations in my page Diet and Cancer, exercise at least 30 minutes per day, keep stress levels down, keep toxic chemicals and xenoestrogens to a minimum and a few other important things I recommend in my free e-book “21 Crucial Things To Do When You Have A Breast Cancer Diagnosis” – you can receive a free copy when you sign up for my newsletters on the right-hand side of this page.
Subscribe For Extra Support
Receive my informative newsletter PLUS my gift to you, these 2 eBooks valued at $47. My subscribers also get a treasure trove of info on nutrition, supplements and lifestyle tips on surviving breast cancer.
You have Successfully Subscribed!
your details are kept 100% private
Search the Site
About Marnie Clark
Hi I'm Marnie Clark, breast cancer survivor, and breast cancer coach. I have 20+ years of experience in natural medicine. In 2004/05 I battled breast cancer myself. You can see more about my journey on my page Breast Cancer Diary.
I've been healthy and recurrence-free since 2004 and in 2012 I became a Breast Cancer Coach because I became aware of the fact that whilst there is now a wealth of information on the Internet, much of it is confusing, conflicting, and sometimes just wrong!
Why should you work with me? Because:
(1) You don't want to go through this journey alone, feeling unempowered, frightened or just plain
clueless about what to do to help yourself.
(2) You will have someone working tirelessly on your behalf, putting together a healing plan for
you so you don’t have to lose your precious energy researching what food you should eat,
what supplements you should take, and what other things you can do that will give you the
best chances for survival. Instead you can spend that time resting, meditating, healing.
(3) You will learn what questions to ask your doctor (and have someone to turn to for the
questions they can't or won't answer).
(4) You will be armed with the tools and strategies you will need to get through the therapies you
choose so you can make your body hostile terrain for cancer.
You can also “like” me on Facebook (Marnie Clark, Breast Health Coach) to get my inspirational snippets, news and updates. I promise to do my utmost to keep you informed and empowered on your healing journey… and beyond.