How the COMT Gene Affects Your Susceptibility to Pain

Can certain genetic variants make you “stronger”?

Pain is a very subjective experience.

What barely perturbs one person can be enough to utterly upend another’s life entirely.

This applies to physical pain—things like thorn pricks, broken bones, etc.—as well as emotional and psychological pain—like the pain experienced after emotional abuse, separation, etc.

We could call this “resilience”—the ability to “move on” after some disturbing or hurtful event.

We would all agree that some people are much more resilient than others. Some are much more able to “move on” and just continue living after a stressful financial matter or a major injury. And others are less so.

What causes those differences? Is it possible that there are genetic factors at play?

A disclaimer: Genetics is NOT the most important factor involved here.

I do not think that a complex phenomenon like resilience can be reduced down to simply genetics alone. In fact, genetics is not even the most important factor involved. Much more important factors are one’s faith, upbringing, and training. These are all far more impactful than genetics and should be given far more attention than they are generally given in modern times.

But that’s a topic for another day.

How does the COMT gene affect your subjective experience of pain?

If you remember from my previous articles:

The COMT gene (among other genes) is responsible for breaking down several important neurotransmitters, including norepinephrine, epinephrine, and dopamine. As summarized previously:

You can have either:

- a “Slow” COMT enzyme, which can predispose you to things like OCD, obsessiveness, anxiety, addictions, difficulty “moving on,” etc. (Check out my previous articles on this).

or

- a “Fast” COMT enzyme, which can predispose you to things like ADHD, difficulty maintaining focus, difficulty persisting on one task for long periods of time, etc. (I’ll be talking about this more in depth in future articles).

Check out my previous articles if you want to rehash the specifics.

Most importantly for this context:

A SLOW COMT gene increases your tendency to persevere on negative experiences of the past.

This includes pain.

So it’s not necessarily that having a slow COMT increases the actual transmission of pain signals within your neurons (nerve cells)—though there some evidence that that may be part of it. Rather, it’s that your mind will tend to persevere on that negative pain experience more than in someone with a fast COMT variant.

You sprain your ankle, and you experience just as much “physical” pain as anyone else, but you tend to persevere on that negative experience. You tend to catastrophize.

And that’s perceived as experiencing “more pain.”

How can deal with that? What measures can you take to improve your resilience? Most importantly, it’s essential to remember that:

You are not just the product of your genetics.

In line with what I said above: You are not just the sum of your genetic variants. There are plenty of people with all the genetic markers you would expect to create the perfect storm—to make them extremely susceptible to pain and rumination on negative physical and emotional events—but they are extremely resilient people.

And as I said, faith, upbringing, and training all have the potential to help here. But I just want to focus on one simple, supplemental measure in this article:

NAC’s potential ability to improve resilience to pain through the COMT enzyme

I’ve written about NAC before. But I just want to discuss briefly its potential benefits in this context.

NAC has the potential to help modulate the function of the COMT enzyme. Some of this effect is mediated through its effect on the activating catecholamines epinephrine and norepinephrine. It helps to modulate their production/breakdown and thus affects the function of the COMT enzyme, which also works on these same neurotransmitters.

Through this effect, NAC can effectively push you from “slow” function of the COMT enzyme to “fast” function (or, at least, faster).

And by doing so, through the mechanisms discussed above, NAC can help reduce your tendency to persevere on negative thoughts and experiences.

Exactly how to dose NAC for an optimal effect is a topic for another day (it’s a bit nuanced), but suffice it to say that NAC has the potential to have a profound impact on this process.

NAC also has effects on other aspects of pain transmission, which can also go to affect this same subjective experience.

Of course, there are many other potential ways to affect this pathway, and what will work for you is not the same as what will work for another. That’s the whole idea of personalized medicine: Personalized medicine is emphatically not about taking random prescription and supplement recommendations from articles written online for a general audience. It’s about figuring out what will work for you specifically, by synthesizing your genetics, history, etc.

And if you’d like to work with me one-on-one (and live in one of the US states in which I am licensed), feel free to reach out.

More coming soon…

Keep in mind that this is not official medical advice. No doctor-patient relationship is established through this article or through any other information provided on this website.