Talking with Carolyn Denton, MA, LN
After years combing digestive health research and finding almost nothing about nightshade sensitivity, it was a relief to finally discover a short informational piece by Carolyn Denton, MA, LN. An integrative nutritionist working in Minneapolis, Minnesota, she knows from personal experience that nightshade sensitivity can be health issue.
Still, her short piece on the utility of elimination diets—and explicitly including nightshades among foods to test for—almost never got written.
“When I was first asked I thought: I don’t want to do it,” she says. “I’m going to write an article for a journal and I’m not going to have any citations. Because no one thinks it’s anything. So I’m just going to put myself out there as a kook?”
A physician colleague changed her mind, appealing to her to share her clinical experience. “You’ve done it for 30 years,” he said. “You need to write this.”
Denton’s interest in food sensitivity began in grad school. She was suffering from a suite of symptoms which would now be diagnosed as fibromyalgia. “I had joint pain and muscle pain and lots of GI problems and fall seasonal allergies and I couldn’t be in humidity without wheezing,” she recalls. And she was fed up: “I’m a young person. I shouldn’t be feeling this way.”
One instructor was working on food sensitivity, and Denton decided to go all in: “I put myself on a ridiculously elaborate elimination diet, far more than what I recommend now. But I wanted to try it, and I found out that I was sensitive to corn and to nightshades.” The cause and effect was crystal clear: if she did not eat corn and nightshades, her symptoms simply went away. Permanently. “I don’t have any of that now,” she says.
Wondering if there could be a genetic connection, she moved on to her family, where three of her siblings had their own inflammatory issues. One had chronic sinus congestions, and was stuffy all of the time. Another was always catching bronchitis, often wheezy, and repeatedly clearing their throat. The third had psoriasis, anxiety, and was resistant to weight loss.
Denton began with sibling three, suggesting a simple test first: remove the corn and nightshades. The anxiety began to lift, some weight dropped off, and the skin cleared. The other siblings then gave it a try, and their symptoms also receded.
Finally Denton approached her father, the most inflamed person she’s ever met. He’d had triple bypass surgery when he was 56 years old despite no real risk factors except that he was really inflamed.
He took a little convincing, but with four kids singing its praises, eventually he tried an elimination diet. Then he adopted it as a lifestyle. “To this day, which has been three decades, he has never re-introduced the foods, which is how you find out what you’re sensitive to. Part of it is that he’s German and he can’t help himself,” she laughs. “But he just feels better.”
“To me it doesn’t matter that there is not ‘data.’ I have data sitting in my office day after day after day,” she says. “I have oodles of stories like this.”
THINKING OUTSIDE THE TOOLBOX
Denton sees patients at the Penny George Institute for Health and Healing and in her own private practice. Her career has coincided with a slow awakening of the medical profession to the principles of integrative medicine, which focuses on the whole patient.
She sees a lot of fibromyalgia patients because of her experience with that complex of symptoms. These patients might first wind up seeing a rheumatologist, a neurologist, or a digestive specialist—all depending on which symptoms were foremost at the time of the referral.
One problem with the scattered symptoms often associated with food sensitivities is that they can influence which doctors you see. Each specialty has its own diagnostic toolbox, but also their own blind spots. Each specialty has their own unique hammer, and they’re looking for the corresponding nail.
But who builds a cabinet with just one tool? And if the actual issue is driven by food sensitivity, many specialists don’t often actually have tools. It’s a difficult and not-that-sexy research topic, so literature is scarce. And there is no drug or procedure that you can prescribe to fix it.
As a nutritionist, Denton teases a gastroenterologist friend who doesn’t generally talk to patients about what they eat. His world view seems largely defined by the various scopes he can utilize, and the power to prescribe Omeprazole and biologics. “I think that they forget that the gastrointestinal system is the immune system, basically,” says Denton. “Gut associated lymphatic tissue (GALT) is a huge part of this whole food sensitivity story, I think.”
While there are still pieces missing to this puzzle, Denton believes the evidence is mounting that food sensitivity manifests as many different kinds of inflammation, driving gut problems, skin problems, breathing problems, joint pain, and autoimmunity.
CHANGING THE PARADIGM
When she begins working with a patient with a lot of apparent inflammation or immune system issues, Denton usually starts with an elimination diet.
This is a departure from usual medical diagnostic procedures, which involve expensive immune assays. “It’s not going to be detected with an allergy test,” says Denton. “This is something different.”
Indeed, the elimination diet breaks with established medical habits on both the diagnostic and treatment ends of the spectrum.
An elimination diet puts the burden squarely upon the patient. With a lab result, the patient endures a moment of discomfort, and science does the work. With an elimination diet the patient has to do the work—sometimes lasting a month or more—and at least some of the science too.
And when it’s all said and done, there is also nothing to prescribe, no pill to cure the patient or drive profit for the medical system. If a food sensitivity is discovered, the responsibility for treatment lies almost entirely with the patient. You have to commit the time and find substitutes.
That’s the hard truth. Some find it discouraging. But it’s non-invasive and it also just makes sense to many people. Patients can find it revelatory and empowering. “They feel better and that’s all that matters,” says Denton.
EVERY DAY YOU WRITE THE BOOK
Denton can guide these discoveries, but she can’t do it for patients. The key is becoming the scientist, and that begins with detailed record keeping of diet and symptoms. “About the only way to do it is to write things down, then go back and look to see if there’s a pattern.”
Writing it down is important because it allows you to formulate and test hypotheses. It can be so easy to convince yourself of something that’s not really there if you’re not really keeping data for yourself. Sure, you remember the 3 cases of heartburn after eating tomatoes. But perhaps you’ve had it another 5 times with no issue. Unless you’re tracking the details, you’re simply not going to be able to consistently recall your lunch from 8 days ago.
Among Denton’s patients, the primary culprits are wheat, corn, cow dairy, and nightshades. That’s right: even though elimination diet literature often leaves out nightshades, her experience is that they’re a primary culprit. “I find lots of people are sensitive to nightshades.”
But you can’t go into the process assuming anything. A big lesson emerging from science related to food sensitivity is the vast potential for individual variation. These insights come from fields like immunology and microbiology. But it helps to explain, for example, how not everybody who has rheumatoid arthritis has an identifiable food sensitivity, and for those who do, how they are not necessarily sensitive in the same way or to the same things.
The most important thing is coming at the problem with a fresh mind.
There’s another really important reason to take notes: with a strong enough foundation of observations you may be able to find a threshold that allows you to control your symptoms without completely removing the offending ingredient.
Denton, for example, was able to figure out that, for her, frequency matters.
A patient may be zeroing in on feeling bad after they have dairy, but then have dairy with no troubles. The key variable here may be time. Maybe you can have dairy once every 4 days, and perhaps even twice a week. But having it every other day will bring on symptoms.
Without a written record you might draw a false conclusion, and remove an otherwise healthy food from your diet.
While Denton is able to control her nightshade sensitivity with smart eating, every now and then she gets a reminder that the underlying immune issues are still there. A couple of summers ago she went camping with a large group of friends, and as is so often the case the communal table was loaded with delicious nightshades.
“I ate a lot of nightshades the first two or three days. And then my symptoms came back. It’s been decades, and it just returned,” she says. “So I certainly could get myself back into a terrible position if I started eating them more frequently.”
Her patients often ask: “How will I know?”
The simple answer is, your symptoms will return. You’ll get a headache, or your joints will scream, or you’ll sleep poorly. “You’ll know,” says Denton. “Because in 10 days you’re going to feel better. Then when you bring the offending food back in your diet it’s going to clobber you in the head or you’re going to be awake all night.”
With the right tools, patients figure it out for themselves. “That’s really the only way,” she says.