Cutting COMT Inhibitors to Reduce Nerve Pain

Last year I started researching my genes in detail. This mostly entailed running my 23&Me data file through various genetic health reporting systems and researching the most interesting genes listed. One gene caught my eye because it was stated that it had an impact on pain sensitivity. I had been dealing with various levels of nerve pain on my left shoulder and arm which impacted sleep and other activities, so I decided to put some of my focus on this COMT gene.

COMT stands for Catechol-O-methyltransferase, which is an enzymatic process that breaks-down certain neurotransmitters. I have the gene for a slow COMT process. About 30% of the population likely have similar genes. The benefit of my version of this gene is it allows higher levels of dopamine to build up, leading to excellent concentration, creativity, pleasure, and drive in low stress situations. The bad aspect of my version of this gene is a lower tolerance for continuous stress and increased pain sensitivity. (There’s a lot more to any genetic discussion, as you may need to take multiple genes into account, but for this discussion let’s keep it simple.)

One nice thing about knowing your genetics is you can sometimes impact how these genes work using simple adjustments. The COMT gene is just such a gene. There are foods that are COMT inhibitors, meaning they slow down the process further. People with the fast version of the COMT gene can consume lots of these foods to slow down their enzymatic breakdown of neurotransmitters to help increase dopamine. People like me, with the slow version, can instead avoid COMT inhibiting foods to help speed up the process to help flush out adrenaline. I decided to try cutting COMT inhibitors to see what would happen. I was surprised by the results.

Exactly as you would expect from the information I read, I found myself calmer, less anxious when things were tough and I was stressed, and the nerve pain issues I’d been experiencing decreased. One gauge of my pain sensitivity is how much it hurts when I lie down to sleep. Prior to cutting COMT inhibitors I couldn’t lie on my right side at all without triggering uncomfortable pain in my neck. When I stay on the dietary restrictions cutting COMT inhibitors I can sleep on my right side. This became my base measuring tool as I experimented with the diet: did my neck hurt at night when on my right side.

Prior to this, for seven years my doctor and the hospital I’d been going to couldn’t tell me what was triggering the pain. It was a mystery to them. The pain was most intense at my neck, but shot down the C5/C6 nerve pathway which goes down the entire length of the arm. An MRI showed no issues with the vertebrae. When it was at it’s worse, feeling like a knife in my spine, I had to hold my arm over my head to just survive the day. I actually broke a tooth biting down from the intensity of the pain. The pain and numbness would shoot across my back, down the arm and into my hand. Beaumont hospital had me getting traction and doing physical therapy for neck issues even though the MRI showed no problems in my neck. This went on for month after month with no relief. The only thing that helped the intense pain was muscle work on the shoulder done by a substitute physical therapist. I have another entry on this entire story if you’re interested. For this discussion you just need to know the pain was so severe at times I was incapacitated for six months at a time during two different years, and was in milder pain the rest of the time before cutting COMT inhibitors.

After cutting the COMT inhibiting foods I discovered that with my pain sensitivity was low enough that I could sleep on my right side and most of the constant pain was totally gone. I only had pain issues now when I exercised, which I was increasing now that I wasn’t in pain. My goal was to build up the muscles in my back arms and chest to see of better support would help. What I discovered was that with lower pain signals I could actually determine where the pain was actually originating. You see, if you study nerve pain you will read about “referred pain.” Referred pain is pain felt in a part of the body other than its actual source. This seems to be very common with nerve impingement issues. Basically this means the nerve may be pinched in one area, like the neck, but you’ll feel it somewhere else, like down the arm. With the pain levels decreased I discovered that when I exercised I only felt pain in my shoulder. I realized this was the actual location of the impingement. I went to a physical therapist with this information and was diagnosed with a common rotator cuff issue. I’m now doing exercises to correct my shoulder so I can exercise without that shoulder pain.

The main foods I had to cut include: Green Tea, Coffee, Chocolate, and Turmeric. I also avoid green tea extracts, quercetin, rutin, and luteolin, etc., which can be found as ingredients, particularly in supplements. You might notice that all of these are commonly touted for their health benefits. Depending on your genetics, as it turns out, they can be bad news for you as well. I was having a cup of coffee or tea every morning along with a piece of chocolate daily. I also like Indian food, which frequently has turmeric. I was non-stop eating COMT inhibitors every day.

Something I find interesting is I’d always had a love/hate relationship with coffee and green tea. I enjoyed drinking them, and was addicted to having a little every morning, but had a very low tolerance. In the past I realized that green tea made me feel hyped up, even more than coffee, which seemed strange because green tea has less caffeine than coffee. Now I know why. Green tea has some of the strongest COMT inhibitors. It wasn’t the caffeine that was revving me up, it was an abundance of neurotransmitters, which is why I couldn’t tolerate much more than a cup or two without getting jittery. I also noticed that some decaf coffees made me feel as wired as caffeinated coffee. Now I know why. It was the high amounts of caffeic acid in coffee, not caffeine, that was making me buzz. (Despite the name, caffeic acid has no relationship to caffeine.) I’ve actually been trying to quit coffee for decades. I liked to refer to drinking coffee every day as being “on the coffee train” to my wife. Yet, because she made it every morning and liked me to join her I drank a cup every morning. Turns out neurotransmitters are addictive. Drink green tea or coffee and you up your dopamine, norepinephrine, and epinephrine levels and they make you buzz. In my case I didn’t need help with this as I have naturally high neurotransmitter levels already. People with the fast COMT gene are the only people that should need their coffee or tea to function. Now that I’m off these morning indulgences I find I still have plenty of energy, I feel more even keeled, and my pain levels decrease substantially.

I wasn’t sure about chocolate at first, and I didn’t want to give it up. To test I stopped eating chocolate for a few weeks and then ate some every day for a week. Every time I did this the pain returned within a day or two of eating chocolate, and decreased again when I removed it from the diet. This was the one I was saddest about giving up. What’s nice is it seems to take a few days of eating COMT inhibitors before the pain sensitivity increases. That means while I generally avoid these foods, I can still have some chocolate or Indian food or other no-no foods as long as I do so occasionally, not every day.

I’ve found coffee/tea substitutes I really enjoy. I’ll write something up on them soon.

Let me know if you’d like details on how to determine your own COMT genetic data and I’ll post some detailed instructions.

UPDATE: August 23, 2020

After doing a full rolphing series to break down fascia and stretch shortened muscle, followed by stretching exercises, I’ve been able to realign my skeletal system enough that the nerve pinching is almost fully alievated. I’ve been able to consume decaf and chocolate without serious pain settling in, though I’ll be careful as I notice if I don’t keep the exercises up, or if I spend too much time hunched over a keyboard, it starts up again.