The ADHD Genetics
COMT + DBH dopamine profile explains ADHD phenotype
The 30-Second Version
**Duration:** 45 seconds **Setup:** Talking head. Genuine, not performative. **Compliance:** Can say "ADHD," "Adderall" (it's a known prescription), "COMT," "dopamine" (all general/genetic terms). DON'T name what you switched to.
``` [Looking at camera, genuine tone]
"I was on Adderall for years. It worked. But I always wondered — why do I need this?
Then I got my genome analyzed and it was just sitting right there in my DNA.
I have two genes that both drain dopamine out of my brain faster than average. One breaks it down too fast. The other converts it into something else too fast. Hit from both sides.
So my brain is basically always running low on dopamine. And that's ADHD. It's real — but knowing the actual mechanism behind mine changed everything about how I deal with it.
Instead of just taking a stimulant and hoping for the best, I could work with my medical team to actually target the specific pathway that was off.
I'm not anti-medication. It helped me function for years and I'm grateful for it.
But the diagnosis tells you WHAT. Your DNA tells you WHY.
If you've been diagnosed with ADHD, look into your COMT and DBH variants. Might be the most useful thing you do this year.
I publish all my genetic data on my site — you can see the exact variants. I work with a medical team. Everything's linked in bio." ```
**Last line (quotable):** "The diagnosis tells you WHAT. Your DNA tells you WHY."
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I was on Adderall for years. It worked, but I always wondered - why do I need this?
Then I analyzed my dopamine-related genes and the answer was sitting right there in my DNA. 🧵
Two genes control most of your baseline dopamine levels:
COMT: Breaks down dopamine in your prefrontal cortex. I have Val/Val = the "fast" version. Clears dopamine rapidly.
DBH: Converts dopamine → norepinephrine. I have the high-activity version. Converts dopamine away fast.
So my brain is getting hit from both sides:
- COMT is clearing dopamine faster than average - DBH is converting what's left into norepinephrine
Result: chronically low dopamine tone in the prefrontal cortex.
ADHD is real. But understanding the genetic mechanism behind it changed everything about how I treat it.
Knowing this changed my approach completely.
Instead of just flooding the system with more stimulant, I could target the actual mechanism.
Different compounds work differently on COMT vs DBH vs reuptake. Genetics tells you which lever to pull.
I also found out my MAO-A is high-activity, meaning serotonin and dopamine both get broken down fast.
And my serotonin transporter has a deletion variant (SLC6A4) that affects reuptake.
The full picture explained 20 years of symptoms better than any diagnosis ever did.
I'm not anti-medication. Adderall helped me function for years and I'm grateful for it.
But genetics gave me a MAP of why my brain works the way it does — and a way to target the actual mechanism, not just the symptoms.
If you have ADHD, getting your COMT and DBH variants tested might be the most useful thing you do this year. ```
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This is what I put in The Manual every week.
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