What’s the COMT Gene and how is it related to your Hormones?

COMT is a gene that codes for an enzyme in your body that does a very important job of detoxifying certain stress hormones and sex hormones like estrogen. It is called Catechol O-Methyltransferase. COMT helps to detoxify dopamine, catecholamines, and estrogen by transferring a Methyl group to them. Everyone has the COMT gene, but some have forms that work normally, and some have gene variants where the COMT enzyme works not as efficiently. Patients who have the slower COMT gene may have more difficulties dealing with stress or have a higher tendency to suffer from anxiety because their bodies do not clear catecholamines (stress hormones) as quickly.

-Do you tend to have issues with feeling overwhelmed easily?

-Do you wake up feeling “heavy” sometimes?

-Is it hard to get motivated to start certain tasks?

-Do you push through your life and work with strong will power, but feel depleted inside?

-Is it hard to control your thoughts?

-Do you tend to have chronic inflammation?

-Do you have a feeling that maybe your hormones are out of balance?

Many patients with these symptoms may be prescribed anti-anxiety medications, anti-depressants, birth control pills, or ADHD medications. Those may not be options you want to use long term. Those going more of a natural route may be familiar with 5-HTP, or St John’s Wort to try to increase serotonin. But serotonin is not the only player, and one must consider dopamine, catecholamines and estrogens levels. COMT genetic mutations, or lack of nutrients that support COMT can make a huge difference in finally getting answers to some mood, inflammatory, or hormonal imbalance issues. 

What are the COMT Gene Types?

Naming the Genes: Most genetic reports may show you have either (-/-), (-/+), or (+/+); one gene from mom and one from dad. 

Normal Type (-/-) or also referred to as GG or Val/Val. Most of the world’s population has this genotype and it is associated with better adaptation to stress. 

Slow Type (+/+) or also referred to as AA or Met/Met. 20-30% of the population has this genotype. It is associated with slower detoxification of stress hormones and slower detoxification of estrogen. Since it also detoxifies dopamine slower, there may be an advantage in more dopamine activity and lower risk of memory issues or Parkinson’s disease. 

Combination Type (-/+) have one normal gene and one slower gene. 

COMT and Estrogen

Did you know that most hormone tests you get through your gynecologist only tests total hormones, not what your body does with them. Your liver and intestinal tract is very important for detoxifying and processing your hormones. In a Genova Diagnostics hormone test I run for my patients, we can tell what molecules your liver converts your hormones to. This is important because some of those breakdown products are good (help you stay young, mentally sharp, have a good sex drive, have vibrant skin), but some of the breakdown products are bad (inflammatory, increase cancer risk, contribute to moodiness). 

Case Study:

In the Complete Hormones Test diagram shown, you see COMT is needed to convert to the GOOD estrogen types. The “MeO” stands for methylated estrogens and these are the good guys. As you can see, this particular patient has very low levels of the MeO forms, and not doing a good job converting from the “OH” forms. This may indicate a COMT mutation.

This patient consulted me for fatigue, hair loss, body aches and pains, and PMS. She said she fluctuates between sleeping a lot and having nights of insomnia, but felt that even if she was able to sleep well for a couple weeks, she would still feel tired. She had body aches and pains all over her body and was only 38 years old. She was also concerned with thinning hair, weight gain and some hormone related symptoms. Something just did not feel right to her, but she did not have any particular diagnosis. 

As you can see from her hormone test results, her body is not methylating well and she has more toxic forms of estrogens. With this type of pattern, we may suspect a slower genotype for COMT, it is always important to confirm with a genetic test. After working with her for 3 months, she said she is feeling a lot better overall, her hair is no longer falling out, she has no cramping with her periods, and she no longer feels tired. 

It is important to tell the difference between the need to work around a COMT mutation, or nutrient and hormone imbalances. Even thought COMT detoxifies estrogen, high estrogen levels actually slow down COMT. So a patient may present as if they have slow form of the COMT gene, when their hormone imbalances have slowed ability of COMT to do its job. Another thing to take into consideration is that some nutrient deficiencies can also slow COMT down. This information may be a bit more complicated than you want to know, but finding a doctor who understands and specializes in this can take the guesswork and confusion out for you. Feel free to contact Dr. Emily Chan ND if you need some specialized opinion for your situation.