Indole-3-Carbinol (I3C)

Evidence Level
Limited
2 Clinical Trials
5 Documented Benefits
2/5 Evidence Score

I3C is a glucosinolate-derived compound found in cruciferous vegetables — formed when raw vegetables are chewed/cut, releasing the enzyme myrosinase that converts glucobrassicin to I3C. In the stomach, I3C converts to DIM and other condensation products. Human trials have measured its effect on the mix of estrogen breakdown products in urine. The studies that measured a clinical outcome were run in patients under specialist care, not in healthy supplement users, and conversion to DIM varies widely between people. Its status is not the same everywhere: in Russia indole-3-carbinol is a prescription medicine (Indinol Forto, registration LP-002010), taken as 200 mg twice a day for cyclic breast pain, so the 400 mg a day figure quoted for supplements is that country's drug dose.

Studied Dose 300 to 400 mg/day moved the urinary estrogen marker in the dose-ranging trial and lower doses did not; 200 or 400 mg/day was used in the cervical trial.
Active Compound Indole-3-carbinol (I3C); active metabolites include DIM, ascorbigen, indolocarbazole

Benefits

Shifts a Urinary Estrogen Metabolite Marker

In a placebo-controlled dose-ranging trial in 60 women at increased breast cancer risk, 4 weeks of I3C raised the urinary 2-hydroxyestrone to 16-alpha-hydroxyestrone ratio at 300 and 400 mg/day, while 50 to 200 mg/day did the same as placebo. A phase I study in 17 women found a 66 percent rise in the same ratio, with no further gain going from 400 to 800 mg/day. This ratio is a laboratory marker of how the body processes estrogen. No trial has shown that moving it changes how a person feels, and in that phase I study serum estradiol, progesterone, LH, FSH and SHBG did not change.

Studied Only as a Hospital Add-On After Surgery, Not a Self-Care Use

This research was done in hospital patients, not in supplement users. In a prospective open-label study with no control group, 33 patients taking 200 mg twice daily after surgery were followed for a mean of 4.8 years: 11 needed no further surgery, 10 needed surgery less often, and 12 had no response, while a further 12 patients were lost to follow-up and could not be counted. A separate observational series in 87 Russian children reported lasting remission in 28.7 percent and no apparent effect in 29.9 percent. Neither study had a placebo group, so the natural course of the condition cannot be separated out. The surgical care these patients received is the treatment; I3C was added on top of it.

Studied Only in Women Already Under Gynecologic Care

One placebo-controlled trial randomized 30 women with biopsy-confirmed high-grade cervical lesions to placebo, 200 mg/day or 400 mg/day for 12 weeks. Complete regression on the 12-week biopsy occurred in 0 of 10 on placebo, 4 of 8 on 200 mg and 4 of 9 on 400 mg. That is one small trial in monitored patients, and it has not been repeated. A later randomized study in 12 women with high-grade vulvar lesions found itch, pain and appearance improved, but the biopsy grade did not improve at 6 months. Screening and the care a gynecologist prescribes are what manage these findings.

Liver Enzyme Induction, Which Cuts Both Ways

This has been measured in people, once. In 17 women taking 800 mg/day, CYP1A2 activity rose about 4-fold on a caffeine probe and lymphocyte glutathione S-transferase activity rose 69 percent. Speeding up those enzymes also speeds the clearance of medicines that depend on them, which is why the interaction list below matters: the same induction described here as detoxification is the reason I3C can lower drug levels. No trial has shown that this enzyme shift improves health in someone who is not taking a drug.

Antioxidant and Anti-Inflammatory Effects: Cell Studies Only

These effects come from cell culture and animal work, including NF-kB signalling in cultured cells. No trial has measured an antioxidant or inflammatory outcome in people taking I3C itself. The one human study in this area that lowered a marker of oxidative stress fed 218 g a day of broccoli and other brassica vegetables, not an I3C supplement.

Mechanism of action

1

Conversion to DIM and Other Active Metabolites

I3C itself is largely converted in the acidic stomach environment to DIM (3,3'-diindolylmethane), ascorbigen, and indolo[3,2-b]carbazole (ICZ). I3C is essentially a 'pro-drug' for these active metabolites — DIM is the most studied.

2

CYP1A1/CYP1A2 Induction (Same as DIM)

Promotes estrogen 2-hydroxylation pathway. Same fundamental mechanism as DIM since I3C converts to DIM.

3

Aryl Hydrocarbon Receptor (AhR) Activation

ICZ (indolocarbazole) — an I3C metabolite — is one of the most potent natural AhR ligands. Activates extensive xenobiotic metabolism gene expression.

4

Anti-HPV Effects

Activity against HPV-infected cells has been shown in cell culture. This is a laboratory observation, and no study has shown that taking I3C clears HPV in a person.

Clinical trials

1
Placebo-Controlled Dose-Ranging Trial: Urinary Estrogen Marker in 60 Women
PubMed

Placebo-controlled, double-blind dose-ranging trial of I3C at 50, 100, 200, 300 or 400 mg/day for 4 weeks in 60 women at increased breast cancer risk, 57 of whom completed, measuring urinary estrogen metabolites.

Women at increased breast cancer risk, mean age 47, range 22 to 74.

The urinary 2-hydroxyestrone to 16-alpha-hydroxyestrone ratio rose in the 300 and 400 mg/day groups, while 50 to 200 mg/day behaved like placebo. The ratio is a surrogate biomarker, and no clinical outcome was measured in this trial.

2
Open-Label Series With No Control Group: Airway Papillomas After Surgery
PubMed

Prospective open-label study with no placebo and no control group: I3C at 200 mg twice daily in 33 patients followed for a mean of 4.8 years after surgical removal of papillomas.

Adults and children treated at a hospital voice centre after surgery, including 9 paediatric patients.

11 of 33 patients needed no further surgery while taking I3C, 10 needed surgery less often, and 12 had no response; a further 12 patients were lost to follow-up. Of 9 children, 1 responded completely, 3 partly and 5 not at all. With no control group there is no way to separate the effect of I3C from the natural course of the condition.

Side effects and drug interactions

Common Potential side effects

Generally well-tolerated.
GI distress (nausea, stomach pain).
Skin rash (rare).
Headache.
Tremor and unsteady balance have been reported at intakes around 800 mg/day, above the 200 to 400 mg/day used in the trials. This comes from clinical report rather than a controlled study, and in the one trial that gave 800 mg/day to 17 women for 4 weeks no such problem was recorded.
Liver enzyme elevations, rare. In 2-year gavage studies by the US National Toxicology Program, I3C given 5 days a week caused liver tumours in male mice at 62.5 to 250 mg/kg and uterine adenocarcinoma in female rats at 75 to 300 mg/kg; male rats and female mice showed no such effect. Those doses are far above a 400 mg human dose, which is about 6 mg/kg, and nothing equivalent has been looked for in people.
Hormonal symptoms in sensitive individuals (mood changes, menstrual irregularities).

Important Drug interactions

Oral contraceptives — induces estrogen metabolism; may reduce contraceptive efficacy; consult; consider backup.
Tamoxifen — theoretical interaction; consult oncologist.
CYP1A2 substrates (caffeine, tizanidine, theophylline) — induces CYP1A2; reduces drug levels.
CYP3A4 substrates — modest induction; theoretical interactions.
Warfarin: I3C induces drug-metabolizing enzymes and could change how warfarin behaves. Published human reports of this pairing are lacking, so INR monitoring is the sensible precaution.
Hormone-sensitive cancers — consult oncologist.
Pregnancy/lactation — limited safety data; avoid.

Frequently asked questions about Indole-3-Carbinol (I3C)

What is I3C (indole-3-carbinol) used for?

I3C (indole-3-carbinol) is a compound from cruciferous vegetables sold on the basis of its effect on estrogen metabolism. In human trials it changes the mix of estrogen breakdown products measured in urine, and whether that change makes anyone feel or function better has not been shown. In the stomach it converts into DIM and other compounds, so the two are closely related.

I3C or DIM, which should I take?

I3C is the precursor that converts to DIM (and other compounds) in the body, but this conversion is variable and produces a mix of substances. Many people prefer DIM for a more consistent, defined active. Both target estrogen metabolism.

How much I3C should I take?

Trials used 200 or 400 mg a day. In the dose-ranging study 50 to 200 mg a day did nothing to the urinary estrogen marker while 300 to 400 mg a day did, and a phase I study found no extra effect above 400 mg a day. Note that 400 mg a day is also the dose at which indole-3-carbinol is registered as a prescription medicine in Russia, so this is not a casual serving. Take it with food, and speak to a doctor before taking it daily.

Is I3C safe?

It is generally well tolerated at typical doses. Because it affects hormone metabolism and can interact with medications, those with hormone-sensitive conditions or on prescriptions should check with a doctor. Very high doses are not recommended.

What is Indole-3-Carbinol?

I3C is a glucosinolate-derived compound found in cruciferous vegetables — formed when raw vegetables are chewed/cut, releasing the enzyme myrosinase that converts glucobrassicin to I3C. In the stomach, I3C converts to DIM and other condensation products.

What is Indole-3-Carbinol used for?

Indole-3-Carbinol is researched primarily for Women's Health. In a placebo-controlled dose-ranging trial in 60 women at increased breast cancer risk, 4 weeks of I3C raised the urinary 2-hydroxyestrone to 16-alpha-hydroxyestrone ratio at 300 and 400 mg/day, while 50 to 200 mg/day did the same as placeb…

What is the recommended dosage of Indole-3-Carbinol?

The clinically studied dose is 300 to 400 mg/day moved the urinary estrogen marker in the dose-ranging trial and lower doses did not; 200 or 400 mg/day was used in the cervical trial. Always follow the product label and check with a healthcare provider for personal advice.

Is Indole-3-Carbinol safe, and does it have side effects?

For most healthy adults, Indole-3-Carbinol is well tolerated at studied doses. Reported effects can include: Generally well-tolerated. GI distress (nausea, stomach pain). It may also interact with some medications. Indole-3-Carbinol is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Indole-3-Carbinol interact with any medications?

Possible interactions include: Oral contraceptives — induces estrogen metabolism; may reduce contraceptive efficacy; consult; consider backup. Tamoxifen — theoretical interaction; consult oncologist. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Indole-3-Carbinol?

NutraSmarts rates the evidence for Indole-3-Carbinol as Limited (2 out of 5). It is backed by 2 clinical trials and 8 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(8 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Bell MC, Crowley-Nowick P, Bradlow HL, Sepkovic DW, Schmidt-Grimminger D, Howell P, Mayeaux EJ, Tucker A, Turbat-Herrera EA, Mathis JM Placebo-controlled trial of indole-3-carbinol in the treatment of CIN. Gynecologic Oncology. 2000;78(2):123-9. doi: 10.1006/gyno.2000.5847.PubMedUsed to support: Placebo-controlled randomized trial in 30 women with biopsy-proven high-grade cervical intraepithelial neoplasia, given 200 or 400 mg/day of I3C for 12 weeks. Complete regression on the 12-week biopsy occurred in 0 of 10 on placebo, 4 of 8 on 200 mg and 4 of 9 on 400 mg, and the 2 to 16-alpha-hydroxyestrone ratio changed with dose. This is a single small trial in patients under gynecologic care, and it has not been replicated.
  2. Soldatskiĭ IuL, Onufrieva EK, Steklov AM, Gasparian SF, Strygina IuV The results of adjuvant therapy of juvenile recurring respiratory papillomatosis with the use of indole-3-carbinol. Vestnik Otorinolaringologii. 2011;(5):47-50..PubMedUsed to support: Russian-language observational series, not a randomized or placebo-controlled trial, in 87 children aged 2 to 15 with recurring airway papillomatosis who had already had between 2 and 86 operations. Over a mean 44.8 months of follow-up, 28.7 percent had lasting remission, 41.1 percent had longer gaps between recurrences, and 29.9 percent had no apparent effect. No adverse effects were recorded. The full text is in Russian and hard for an English-speaking reader to check.
  3. Wong GY, Bradlow L, Sepkovic D, Mehl S, Mailman J, Osborne MP Dose-ranging study of indole-3-carbinol for breast cancer prevention. Journal of Cellular Biochemistry. Supplement. 1997;28-29:111-6. doi: 10.1002/(sici)1097-4644(1997)28/29+<111::aid-jcb12>3.0.co;2-k.PubMedUsed to support: Placebo-controlled, double-blind dose-ranging study in 60 women at increased breast cancer risk, 57 of whom completed 4 weeks of I3C. The urinary 2-hydroxyestrone to 16-alpha-hydroxyestrone ratio rose at 300 and 400 mg/day but not at 50 to 200 mg/day. The endpoint was this surrogate biomarker; no clinical outcome was measured.
  4. Reed GA, Peterson KS, Smith HJ, Gray JC, Sullivan DK, Mayo MS, Crowell JA, Hurwitz A A phase I study of indole-3-carbinol in women: tolerability and effects. Cancer Epidemiology, Biomarkers & Prevention. 2005;14(8):1953-60. doi: 10.1158/1055-9965.EPI-05-0121.PubMedUsed to support: Phase I study in 17 women: 4 weeks of placebo, then 400 mg/day for 4 weeks, then 800 mg/day for 4 weeks. Both doses were tolerated. CYP1A2 activity rose in 94 percent of subjects, a mean 4.1-fold, and lymphocyte glutathione S-transferase activity rose 69 percent. The urinary 2-hydroxyestrone to 16-alpha-hydroxyestrone ratio rose 66 percent with no further gain above 400 mg/day, while serum estradiol, progesterone, LH, FSH and SHBG did not change.
  5. Rosen CA, Bryson PC Indole-3-carbinol for recurrent respiratory papillomatosis: long-term results. Journal of Voice. 2004;18(2):248-53. doi: 10.1016/j.jvoice.2003.05.005.PubMedUsed to support: Prospective open-label study with no control group in 33 patients taking I3C 200 mg twice daily after surgical removal of airway papillomas, followed for a mean of 4.8 years. Eleven needed no further surgery, 10 needed surgery less often and 12 had no response; a further 12 patients were lost to follow-up. Among 9 children, 1 responded completely, 3 partly and 5 not at all. No side effects were reported. Without a control group the natural course of the condition cannot be separated from any effect of I3C.
  6. Naik R, Nixon S, Lopes A, Godfrey K, Hatem MH, Monaghan JM A randomized phase II trial of indole-3-carbinol in the treatment of vulvar intraepithelial neoplasia. International Journal of Gynecological Cancer. 2006;16(2):786-90. doi: 10.1111/j.1525-1438.2006.00386.x.PubMedUsed to support: Randomized comparison of I3C 200 versus 400 mg/day, with no placebo group, in women with high-grade vulvar intraepithelial neoplasia; 12 were analysable. Itch, pain and vulvoscopic appearance improved and the 2 to 16-alpha-hydroxyestrone ratio rose, but tissue biopsy showed no improvement in the grade of the lesion over 6 months (P = 0.317), and the two doses did not differ.
  7. Brown GA, Vukovich MD, Martini ER, Kohut ML, Franke WD, Jackson DA, King DS Endocrine and lipid responses to chronic androstenediol-herbal supplementation in 30 to 58 year old men. Journal of the American College of Nutrition. 2001;20(5):520-8. doi: 10.1080/07315724.2001.10719061.PubMedUsed to support: Randomized, placebo-controlled 28-day study in 55 men of a six-ingredient product containing 450 mg/day indole-3-carbinol alongside androstenediol, saw palmetto, chrysin, GLA and Tribulus. Total testosterone and PSA did not change, while free testosterone rose 37 percent, dihydrotestosterone rose 57 percent and estradiol rose 86 percent, and HDL cholesterol fell. The androstenediol is what raised those hormones, and the authors concluded the combination did not prevent estradiol and dihydrotestosterone forming. I3C cannot be separated from the other five ingredients, and this is the closest thing that exists to a study of I3C in men.
  8. Bradlow HL, Michnovicz JJ, Halper M, Miller DG, Wong GY, Osborne MP Long-term responses of women to indole-3-carbinol or a high fiber diet. Cancer Epidemiology, Biomarkers & Prevention. 1994;3(7):591-5..PubMedUsed to support: Randomized three-arm study, 20 women per arm, comparing I3C 400 mg/day, 20 g/day alpha-cellulose and placebo for 3 months. The urinary 2-hydroxyestrone to estriol ratio rose in the I3C arm by month 1 and stayed raised, with no change in the placebo or fibre arms, though 3 of the 20 women on I3C showed no change at any time point. The endpoint is a urinary marker, and the ratio measured here uses estriol rather than 16-alpha-hydroxyestrone.