3,3'-diindolylmethane modulates estrogen metabolism in patients with thyroid proliferative disease: a pilot study.
BACKGROUND
The incidence of thyroid cancer is four to five times higher in women than in men, suggesting a role for estrogen (E₂) in the pathogenesis of thyroid proliferative disease (TPD) that comprises cancer and goiter. The objective of this study was to investigate the antiestrogenic activity of 3,3'-diindolylmethane (DIM), a bioactive compound derived from cruciferous vegetables, in patients with TPD.


METHODS
In this limited phase I clinical trial study, patients found to have TPD were administered 300 mg of DIM per day for 14 days. Patients subsequently underwent a total or partial thyroidectomy, and tissue, urine, and serum samples were collected. Pre- and post-DIM serum and urine samples were analyzed for DIM levels as well as estrogen metabolites. DIM levels were also determined in thyroid tissue samples.


RESULTS
DIM was detectable in thyroid tissue, serum, and urine of patients after 14 days of supplementation. Urine analyses revealed that DIM modulated estrogen metabolism in patients with TPD. There was an increase in the ratio of 2-hydroxyestrones (C-2) to 16α-hydroxyestrone (C-16), consistent with antiestrogenic activity that results in more of C-2 product compared with C-16.


CONCLUSIONS
Our data suggest that DIM enhances estrogen metabolism in TPD patients and can potentially serve as an antiestrogenic dietary supplement to help reduce the risk of developing TPD. The fact that DIM is detected in thyroid tissue implicates that it can manifest its antiestrogenic activity in situ to modulate TPD.
Department of Microbiology and Immunology, New York Medical College, Valhalla, New York 10595, USA.
Shilpi
S
Rajoria
Robert
R
Suriano
Perminder Singh
PS
Parmar
Yushan Lisa
YL
Wilson
Uchechukwu
U
Megwalu
Augustine
A
Moscatello
H Leon
HL
Bradlow
Daniel W
DW
Sepkovic
Jan
J
Geliebter
Stimson P
SP
Schantz
Raj K
RK
Tiwari
D004967:Estrogens / Q000378:metabolism* / Q000652:urine; D005260:Female; D006801:Humans; D007211:Indoles / Q000378:metabolism / Q000494:pharmacology* / Q000652:urine; D010865:Pilot Projects; D013961:Thyroid Gland / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000378:metabolism* / Q000601:surgery; D013965:Thyroidectomy
D004967:Estrogens; D007211:Indoles; C016392:3,3'-diindolylmethane
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