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COMT stands for catechol-O-methyltransferase. This is an enzyme which is used to degrade catecholamines. We have three major catecholamines:
This is often called our "feel good" neurotransmitter. Dopamine triggers the brain’s "reward system."
But dopamine does not simply make us feel good. It is associated with repetitive behavior. Dopamine stimulates the brain to repeat behavior that triggers the release of more dopamine. This is why it is associated with addictive behavior. People do things that triggers the release of dopamine. They feel good for a movement and then seek to repeat the behavior to get more dopamine.
Dopamine is neither good nor bad. We need some of it for motivation, concentration and feeling pleasure. However, too much can become overly stimulating.
Epinephrine is adrenaline. This is an emergency, stimulatory neurotransmitter. We need some epinephrine to respond to life events and provide energy to get us through true emergency situations.
On the other hand, if epinephrine is elevated all the time then it feels like we are in an emergency situation that never stops. This can lead to chronic feelings of anxiety.
COMT enzyme activity is regulated by several genes, most notably COMT v158m.
The "warrior" type has high production of COMT. These people can quickly degrade dopamine and epinephrine. This gives them an advantage in being able to calm down after a stressful event.
Just because someone has a gene that predisposes them for a condition that does not mean they will have symptoms. Genetics are complicated. We have many genes, that work together, under the influence of environmental triggers to produce symptoms.
Having "worrier" COMT genes does not mean you will inevitably have symptoms of anxiety and go through life as a worrier. Likewise, having the "warrior" genes does not make you impervious to stress.
When working with clients my starting point is never genetics. In fact, for most cases I do not even bother with looking at genetics. We have many other factors that can influence mood such as the stress from life events and hormonal issues. Emotions should not be reduced down to a few genes.
However, it is important to recognize times when genetic testing may be helpful.
The several following issues may come up with slow COMT activity:
Increased sensitivity to stress and anxiety
Issues with estrogen metabolism. COMT is also needed to detoxify catechol estrogens. This can lead to hormonal effects as well. Supplement that help the liver detoxify estrogens may be needed
Sensitivity to folic acid supplements.
When genetic testing started to become popular, many people were told to supplement with folate based upon their MTHFR genetics. I can remember one particular case of a woman who had previously consulted with another naturopath who had made a name for himself as the folate/methylation expert. Based upon genetic testing he recommended a large dose of folate which made her anxiety symptoms much worse.
Folate increases production catecholamines. So for people with slow COMT and anxiety, taking a folate supplement is akin to putting fuel on the fire. They may have extreme symptoms with tiny doses.
This is true even if genetics and blood testing say someone needs more folate. None of that matters if COMT is slow. You then have to work on COMT first before doing anything with folate.
About the time I was in naturopathic school is when genetic testing for folate first became popular. Overnight everyone was talking about folate and how essential it is. How everyone has methylation issues and nutraceutical companies where brining out products with high doses.
This is often how the supplement industry works. Some promising research come out and then suddenly everyone is trying to make money off it it. We’ve seen this with folate, vitamin D, tumeric and now CBD. I don't wish to imply that these supplements do not help people. They are all good. That does not mean they are all miracle supplements that everyone needs to take either.
The point is that at first we were told so many people have genetic methylation issues and need large doses of methyl folate. A few years later and I go to same lectures and am told to be cautious of folate because some people with slow COMT production will not respond well to it.
The lesson to learn here is that genetic testing can be helpful, but it is not as simple as a single gene means you need to take so much of a specific nutrient. Single genes rarely cause diseases themselves. Testing COMT genetics is a tool. I have seen it be very helpful in some cases of anxiety. However, it is just one consideration.
I believe that the more we know about genes, the more we will learn how supposed "bad" genes may have their own advantages.
Lower COMT activity is associated with positive factors such as better cognition, memory, brain plasticity and ability to feel more pleasure. The COMT types, "warrior" or "worrier" are not good or bad. This is just human variation.
If you have already had your genes tested by a company such as 23 and me, you can download your raw data and send it to another company for interpretation.
Once such service I like is promethease. It's a cheap and simple way to find out what is in your genes.See if your doctor can have the genetics tested on blood work. Doctors commonly run tests for MTHFR genes C677T and A1298C. Panels may be available which also include COMT. It is best to have both tested.
This is an advanced test that cover COMT, folate and much more. It only needs a small amount of blood from a skin prick, so there is no need to go to a lab. It is a somewhat expensive tests, but it only has to be done once and then you’ll have a lot of important information to know about your genes for the rest of your life.
Go here fore more information on the methylation blood spot test.
I keep these kits in the office and in certain cases just running a comprehensive genetic test such as this is best.
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