Pilot study: Effect of 3,3 '-diindolylmethane supplements on urinary hormone metabolites in postmenopausal women with a history of early-stage breast cancer

Dietary indoles, present in Brassica plants such as cabbage, broccoli, and Brussels sprouts, have been shown to provide potential protection against hormone-dependent cancers. 3,3'-Diindolylmethane (DIM) is under study as one of the main protective indole metabolites. Postmenopausal women aged 50-70 yr from Marin County, California, with a history of early-stage breast cancer, were screened for interest and eligibility in this pilot study on the effect of absorbable DIM (BioResponse-DIM(R)) supplements on urinary hormone metabolites. The treatment group received daily DIM (108 mg DIM/day) supplements for 30 days, and the control group received a placebo capsule daily for 30 days. Urinary metabolite analysis included 2-hydroxyestrone (2-OHE1), 16-alpha hydroxyestrone (16alpha-OHE1), DIM, estrone (E-1), estradiol (E-2), estriol (E-3), 6beta-hydroxycortisol (6beta-OHC) and cortisol in the first morning urine sample before intervention and 31 days after intervention. Nineteen women completed the study, for a total of 10 in the treatment group and 9 in the placebo group. DIM-treated subjects, relative to placebo, showed a significant increase in levels of 2-OHE, (P = 0.020), DIM(P = 0.045), and cortisol(P = 0.039), anda nonsignificant increase of47% in the 2-OHE/16alpha-OHE1 ratio from 1.46 to 2.14 (P = 0.059). In this pilot study, DIM increased the 2-hydroxylation of estrogen urinary metabolites.