Last reviewed: May 12, 2026 Last updated: May 12, 2026

Written by: Jay Hastings , CEO of PlexusDx

Jay Hastings is the CEO of PlexusDx, a precision health company focused on genetic testing, blood biomarker insights, and personalized wellness recommendations. He has more than 20 years of experience across healthcare innovation, genomics, laboratory operations, healthcare investing, and strategic finance. His work has included scaling healthcare startups, leading CLIA lab integrations, and helping expand consumer access to precision health tools.

Medically reviewed by: Jayden Lee, PharmD, EMBA

Jayden Lee, PharmD, EMBA, is the PlexusDx Medical Science Liaison with a PharmD and MBA specializing in pharmacogenomics and clinical product development, with a proven ability to bridge the gap between genomic research and practical patient outcomes. Dr. Lee has more than 10 years of professional experience in clinical pharmacy, academia, and research.

This article is part of the PlexusDx Education Hub — your resource for evidence-based guidance on brain & cognitive health. Browse all Brain & Cognitive Health education

Hoarding — persistent difficulty discarding possessions and the distress that comes with it — is often misunderstood as simple untidiness. It is a recognized clinical pattern with real biological roots. Twin and family studies show a meaningful genetic contribution, and variants in genes that shape dopamine and serotonin signaling, including COMT, help explain why decision-making around possessions can feel so difficult for some people.

What hoarding is and its clinical context

Hoarding disorder is characterized by ongoing difficulty parting with items regardless of their value, driven by a perceived need to save them and distress at the thought of discarding. The result is accumulation that can crowd living spaces and interfere with daily life. It is distinct from ordinary collecting or clutter, and it is now recognized as its own clinical entity rather than a subtype of obsessive-compulsive disorder.

Is hoarding genetic? Twin and family studies

Research consistently finds that hoarding runs in families. Twin studies estimate that a substantial share of the variation in hoarding behavior is heritable, with the remainder shaped by environment and life experience. Having a first-degree relative with hoarding tendencies raises the likelihood of similar patterns. As with most behavioral traits, this reflects many genes of small effect, not a single hoarding gene.

COMT and dopamine-driven decision-making

COMT codes for an enzyme that breaks down dopamine in the prefrontal cortex, the brain region central to planning, judgment, and deciding what to keep or discard. The well-known Val158Met variant changes how quickly dopamine is cleared, influencing cognitive flexibility and decision-making under uncertainty. Because hoarding involves difficulty with exactly these decisions, COMT is a biologically plausible contributor and a frequent focus of research on compulsive and decision-related traits.

Serotonin signaling and related variants

Serotonin biology also appears relevant. SLC6A4, the serotonin transporter gene, shapes how serotonin is recycled at the synapse and has been studied across anxiety- and compulsion-related traits. BDNF, which supports neuron growth and plasticity, is another gene of interest in emotional regulation. Variants like SAPAP3 have been examined in obsessive-compulsive-spectrum behaviors. No single one determines hoarding; together they sketch the neurochemical terrain.

Genetics as one factor among many

Genetic tendencies do not act in isolation. Life events, trauma, learned behavior, and environment all interact with inherited biology to shape whether and how hoarding develops. This is why two people with similar genetics can differ dramatically, and why genetics is a guide, not a guarantee. Understanding a predisposition can reduce shame and self-blame — a tendency is not a character flaw.

The Precision Peptide Genetic Test analyzes 14 pathways, 49 peptides, 150+ genetic insights across peptide-related biological pathways, including systems connected to neurotransmitter signaling and cognitive biology. It offers educational, pathway-level context about your body — not a diagnosis of hoarding disorder or any mental health condition.

What to do with the information

Hoarding responds to support, not judgment. Evidence-based help centers on qualified mental health professionals; cognitive behavioral therapy adapted for hoarding is among the most studied approaches, and a provider can tailor it to the individual. Practical strategies — structured decluttering with support, and reducing isolation — often complement professional care. Genetic insight is not a treatment; it is context that can make it easier to seek help early and without shame.

Curious how your genetics shape neurotransmitter and cognitive pathways? The Precision Peptide Genetic Test analyzes your DNA across peptide-related systems so you can bring informed questions to a qualified provider. Test before you invest in any protocol.

Frequently Asked Questions

Is hoarding genetic?

Hoarding has a meaningful genetic component. Twin studies suggest a substantial share of the variation in hoarding behavior is heritable, with environment and life experience contributing the rest. It is polygenic — many small-effect variants rather than one gene. Family history raises likelihood without guaranteeing that hoarding will develop.

What role does COMT play in hoarding?

COMT codes for an enzyme that clears dopamine in the prefrontal cortex, the region behind decision-making and cognitive flexibility. Its Val158Met variant alters dopamine signaling, which may influence the difficult keep-or-discard decisions central to hoarding. COMT is a biologically plausible contributor, but it is one of many factors, not a cause on its own.

Can genetic testing diagnose hoarding disorder?

No. Hoarding disorder is diagnosed by a qualified mental health professional through clinical assessment, not by a gene test. Genetic insight can describe tendencies in neurotransmitter-related pathways for educational context, but it cannot diagnose, treat, manage, or predict any mental health condition. Support belongs with a licensed provider.

Does having these variants mean I will develop hoarding?

No. Variants in genes like COMT or SLC6A4 shift tendencies in neurotransmitter signaling; they do not determine behavior. Environment, life experience, and learned patterns all interact with genetics. A predisposition is a map, not a verdict, and understanding it can make it easier to seek support early if difficulties arise.

The Precision Peptide Genetic Test analyzes how your genes influence peptide-related biological pathways. It does not recommend, prescribe, or determine which peptides you should use, and it does not diagnose, treat, cure, manage, or prevent any medical condition. Consult a qualified healthcare provider before making decisions about your health.

Medical and Editorial Standards

Medical review process: This article was reviewed for medical accuracy, scientific clarity, evidence alignment, and appropriate discussion of genetics, medications, supplements, biomarkers, and health-related claims.

Sources and evidence: PlexusDx educational content is developed using peer-reviewed research, clinical literature, reputable medical references, and, where applicable, public health or regulatory guidance. References are included at the end of the article when scientific, medical, or health-related claims are discussed.

Commercial transparency: PlexusDx offers genetic testing, blood biomarker testing, personalized supplement recommendations, and related precision wellness services. Product mentions are intended to help readers understand available options and should not be interpreted as medical advice.

Important disclaimer: PlexusDx educational content is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about medications, supplements, genetic testing, lab testing, or health-related care.

This article is part of the PlexusDx Education Hub. Browse all Brain & Cognitive Health education