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.

Are Toxic Estrogens Causing Weight Gain In My Hips and Buttocks? Could This Also By Why My Sex Drive Is Low?

Estrogen is thought of as a female hormone, but men have it too. In fact the way estrogen is processed by the liver is often an overlooked factor when men want to improve their libido and raise testosterone levels. Certain types of estrogens that are more prevalent in the body can affect a woman’s risk for breast cancer, PMS, as well as her mood stability. In both genders estrogen toxicity can contribute to difficulty losing weight. Weight distribution in the hips and thighs can be a sign of estrogen toxicity. 

So you see it is important to understand a bit more about the role of estrogen in your body so that you improve the areas of your health that are affected by your hormones. 

What Does Estrogen Do? There are 3 types of estrogens in the body. Estrone (E1), Estradiol (E2), and Estriol (E3). Estrogens are made in the ovaries of premenopausal women. Other tissues that produce Estrogen are your adrenal glands and fat cells. So the more fat you have, the more estrogen is produced. Estrogen is important for secondary female characteristics, the thickening of the uterine lining, bone health and vaginal lubrication in women. It is responsible for maturation of sperm in men. 

What's the Problem With Estrogen Dominance? However, there is a rising problem of estrogen dominance in both men and women. This means there is too much estrogen, or an imbalance of how estrogen is processed through the liver. The body makes estrogen but it also needs to get rid of it in a healthy cycle. The liver and intestinal tract are key players to the detoxification of estrogen. Depending on what position on the estrogen molecule a methyl or hydroxyl group binds in the detoxification process, determines if the estrogen does its job, or becomes pro-inflammatory and proliferative. 

The problem with estrogen dominance is that it can contribute to proliferation. Proliferation is growth of tissues such as increased chance of breast cancer, fibrocystic breasts, uterine fibroids, endometriosis etc. Estrogen dominance also can lead to more inflammation, PMS, hormonal migraines, as well fat distribution around the buttocks, hips and thighs, an inability to lose weight, and decreased sex drive in both genders. 

Is Your Sex Drive Low? If sex drive is something that is of concern and you are also overweight, estrogen dominance becomes a vicious cycle because fat cells contain an enzyme called Aromatase. Aromatase converts testosterone into more estrogen, depleting testosterone. This is one of the reasons to be considered when the modern male suffers from low levels of testosterone. They say, the more belly fat a man has, the less sex he has. Testosterone levels are generally falling in our population and men in their 50s today have testosterone levels of men in their 70s in the 1960s.  Also because many chemicals and plastics we use today mimic the estrogen molecule, there is an increased incidence of estrogen dominance. So it would be wise to decrease your use of plastic containers and definitely not microwave in plastic or leave a plastic water bottle sitting in a hot car. 

Is Your Weight In Your Buttocks and Hips? If weight is something that is of concern, estrogen dominance becomes a vicious cycle because fat cells contain an enzyme called Aromatase. Aromatase makes more estrogen. Estrogen is known to be a risk factor for obesity in both genders. Weight gain can lead to insulin resistance (blood sugar problem), which further can lead to more weight gain. There is a supplement, Aromastat from Dr. Peter D’Adamo available on my online store. It works by decreasing the effects of Aromatase. 

There are 3 things you can do to decrease estrogen dominance.

1. Decrease exposure to zenoestrogens like plastics, parabens, bisphenol A, phthalates, PCBs, BHA (preservative), and red dye number 3.
2. Eat 1-2 cups of broccoli, cabbage, cauliflower or Brussels sprouts per day. They contain Indole-3 Carbinol, which helps the liver get rid of toxic estrogens. A study shows that eating just 2 servings of broccoli per day reduced the risk of some cancers by 50%.
3. Reduce the amount of alcohol and coffee. Alcohol increases the amount of estrogen in the blood because it competes with the liver. Coffee increases the receptors for estrogen, making it more potent.

What Are The Best Tests? Lastly, how do you know your estrogen metabolism is out of balance? The tests that are usually run in medical offices only test for the total amount of estrogen, which in many cases may be normal even if your estrogen metabolism is imbalanced. A blood test includes both free hormone and bound hormone for a total level. It is important to know how much free hormone you have, because that is what is active in the body. Only a saliva or urine test can give you the free hormone level and therefore it is superior to a blood test for this purpose. I also offer more comprehensive tests that give specific breakdown products of what the liver does with estrogen.

Is the type of estrogen you have pro-inflammatory, and proliferative? Normal tests do not tell you this. So if you feel that you have an imbalance in your hormone metabolism and it is contributing to your weight issues, libido, menopausal changes, PMS or mood swings, I can help you find out exactly where your hormonal pathways are aberrant and design a strategy to get you the results you need. Please contact me to set up an appointment. I can work with you both in office or virtually.