Brain chemistry: COMT–fast, slow, or average?

Due to the enormous pile of information that is being gathered since the Human Genome Project began, statistics are being generated that begin to reveal some significant differences amongst us.  Our bodies have about 20,000 genes to get all the jobs done that our miraculous bodies do.  COMT (catechol-o-methyl transferase) is the gene that is responsible for handling dopamine — fast, slow, or average—which results in your tendency to have a certain amount of energy, happiness, and enthusiasm.  

Notice I said the COMT gene will determine your tendency to be a certain way?  Other factors will play a role in how you end up feeling, how much energy you have, how motivated you feel etc.  But the genes you inherited will decide if you have… a 2 cylinder or an 8 cylinder engine to start with.  It will determine if you tend to metabolize the dopamine in your cells quickly, or you might clean out dopamine much slower than others.    Since dopamine determines the energy we tend to have, let’s talk about how that might feel.  Most everything in our bodies has an ideal level to operate well for a long time.  A sweet spot if you will. Running too high is going to eventually result in problems.  Too low doesn’t feel good, either.  Somewhere in the middle is best. 

So, If you inherited a slow system for metabolizing  dopamine, (SLOW COMT), this  results in higher dopamine levels left in your brain cells.  These folks tend to be faster thinking, lots of energy, life has zing!  These folks wake up ready to do things, talk faster, and be more creative.  However, if you inherited a slow system for emptying dopamine,  the levels can get too high… and this can cause problems.  When dopamine gets too high, it’s hard to focus (ADHD), anxiety can occur, anger can occur, and its difficult to sleep. Its hard to stop dwelling on things, obsessiveness increases.  (If dopamine gets really high, that’s when thoughts get so fast people can have psychotic symptoms—seeing or believing things that aren’t real.)   Difficulty sleeping for a SLOW COMT is usually experienced as the inability to fall asleep in the first place, typically staying awake too long while worrying about tasks the next day, etc.  

If you inherited the other system for handling dopamine, then you inherited a more rapid emptying of dopamine—RAPID COMT.  This results in lower levels of dopamine hanging around in brain cells and, as a result, people tend to feel tired.  Tired, uninterested in things (apathy), unattached, no zing.  You often find you couldn’t-care-less and might have attention problems like a staring-out-into-space type of ADD.  Those who metabolize dopamine more quickly, RAPID COMT, may get too low and suffer from depression and anxiety—but this anxiety tends to feel morbid in nature.  These folks tend to feel anxious as if something bad is about to happen for no reason at all, sometimes thinking about horrible, bad things out of no where.   But, while too much dopamine causes some folks difficulty sleeping, too little of dopamine also causes difficulty sleeping (remember that sweet spot?). Usually a RAPID COMT person can fall asleep for a while, but are unable to stay asleep for long, waking up more often.

Approximately half of people have an Average COMT system but  can find themselves with symptoms like a RAPID or a SLOW COMT. But fortunately for them, those with an average COMT tend to be easier to fix as most medications work best for those who have an average emptying system.  Those with a RAPID COMT have often tried many medications that didn’t seem to work because their rapid emptying system can even empty the dopamine the medication is trying to increase. SLOW COMT patients often find difficulty reducing daily anxiety as they get older, as their system is easily overwhelmed by higher levels of dopamine and find that medications like Xanax or Ativan seem to be the only thing that helps.

Understanding how to best help any brain chemistry symptom starts with understanding which type of COMT system you have, but isn’t always necessary.   Dr. Ben Lynch has explained much of this in his book “Dirty Genes”, but you can also get tested to help sort things out.  Genesight is an oral genetic swab done to evaluate which medications are best for certain individuals, but they stopped testing the gene for COMT in 2019 (due to issues of insurance reimbursement).   So if you have had a Genesight test by Assurex prior to 2019, your COMT system should be on your report. Please note, because insurance companies are involved with Genesight testing, the rules are strict about a formal visit with a physician in order for you to get test results.

 Other options:

-Strategene report generated from  a 23 & me Health Report  ($199 on amazon:  This test often goes on sale during holidays but you must order the Health Report, not just the Ancestry portion. It takes 4-5 weeks to get your 23 & me  results after sending in your saliva sample, after which you can generate a report in a few minutes from a search engine from Strategene by Dr. Ben Lynch for additional $45. (If you are particularly data savy, you can retrieve your COMT results yourself without the Strategene report under the RAW DATA section in your 23 & me results–look for rs4680 & rs4633.)

-online COMT ordering  (often with MTHFR, which I highly recommend) by various companies such as the MTHFR Doctors.

lab order by your provider — most lab drawing stations & hospitals can send your blood for COMT testing to the nearest Lab Corp facility for your COMT variations as long as it is ordered by a licensed provider. This also requires a consultation with your provider due to regulations and cost is dependent on the facility billing for your lab.

Please see & Dr. Ben Lynch you tube posts  for additional information to help specific symptoms coming soon.  

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