GERD isn’t just about excess acid. Explore how microbial imbalance, mold exposure, and even low stomach acid contribute to reflux—and what functional strategies can offer lasting relief.
Heartburn is so common it’s almost become a punchline. But for millions of people, it’s not funny—it’s disruptive, distressing, and often dismissed. More than 60 million Americans experience heartburn at least once a month, and up to 20% live with chronic reflux symptoms that interfere with daily life.
But what if GERD isn’t just about acid?
That’s the core message of GERD Uncovered, a comprehensive guide by Dr. Kristina Carman, a Senior Fellow at the Independent Medical Alliance and a naturopathic doctor with deep expertise in functional nutrition. With contributions from IMA Co-Founder Dr. Paul Marik, and Senior Fellow Dr. JP Saleeby, this isn’t just a list of symptom tips—it’s a full-spectrum overview of how reflux happens, why it persists, and what truly effective recovery looks like when root causes are addressed.
Whether you’re a patient seeking deeper answers or a practitioner ready to move beyond the proton pump inhibitor (PPI) playbook, this guide is for you. It also pairs perfectly with Dr. Carman’s companion article, “GERD Is Not Just About Acid: A Functional Medicine Perspective on Root Causes and Lasting Relief.”
📖 What’s in the Guide?
This isn’t just another reflux checklist. GERD Uncovered walks readers through the full landscape of GERD—what it is, how it’s diagnosed, why it happens, and what can be done about it from a root-cause, whole-body perspective. Designed for both patients and practitioners, it connects the dots between symptoms, testing, lifestyle, and long-term recovery.
- 📚 Definition and Diagnosis
- 🧪 Functional & Naturopathic Diagnostic Approaches
- 🔍 Clinical Criteria and Differential Diagnosis
- 🌐 GERD as a Systemic, Multifactorial Condition
- 🚨 Symptoms and Red Flags
- ⚠️ Potential Causes of GERD
- 🍽️ Tips for Managing GERD Symptoms
- 💊 Supplement Support for GERD
GERD Is Not Just About Acid: A Functional Medicine Perspective on Root Causes and Lasting Relief
By: Kristina Carman, ND, advNT
If you’ve struggled with reflux, heartburn, or that all-too-familiar burning in your throat, you’re far from alone. Gastroesophageal reflux disease (GERD) affects up to 20% of adults in developed countries, and conventional treatment often starts and ends with one option: acid suppression.
Proton pump inhibitors (PPIs), H2 blockers, and antacids can offer temporary relief—but they rarely address why the reflux is happening in the first place. And for many people, these medications create long-term issues like nutrient malabsorption, microbial imbalance, and poor immune function.
From a functional and naturopathic medicine perspective, GERD is more than just a local problem at the lower esophageal sphincter (LES). It is a whole-system disruption, involving gut function, microbiome balance, inflammation, hormone signaling, stress physiology, and even environmental toxicants like mold.
This article brings together the key findings from a comprehensive GERD guide designed to empower both clinicians and patients with the root-cause roadmap for long-lasting relief.
Redefining GERD: More Than an Acid Problem
Traditional medicine views GERD as a consequence of excess stomach acid irritating the esophagus. But in clinical reality, low stomach acid (hypochlorhydria) is often the silent driver behind the pressure, fermentation, and reflux symptoms.
Why? Because low acid impairs digestion, slows gastric emptying, and allows food to ferment—producing gas that increases intra-abdominal pressure and pushes stomach contents upward.
GERD, therefore, isn’t simply about acid quantity—it’s about acid misplacement in a context of poor digestion and systemic imbalance.
👉 Learn more: The Real Root Causes of GERD (Plus a Little Mythbusting)
Root Causes of GERD: A Functional Lens
Our guide walks through the multi-system contributors to reflux. Here’s a snapshot:
- Low stomach acid – Often due to stress, aging, H. pylori, or nutrient deficiency (e.g., zinc)
- H. pylori infection – Suppresses acid, inflames the stomach lining, and worsens motility
- SIBO and dysbiosis – Gas-producing bacterial overgrowth contributes to pressure and bloating
- Impaired bile flow – Sluggish or absent bile can cause bile reflux, commonly mistaken for acid reflux
- Poor motility – Vagal nerve dysfunction, hypothyroidism, or mold exposure can reduce gastric emptying
- Microbiome imbalance – Promotes inflammation, β-glucuronidase activity, and leaky gut
- Food and lifestyle factors – Meals too large, too late, or high in fat, plus alcohol, caffeine, and poor chewing
- Structural causes – Hiatal hernia, obesity, and poor posture contribute to mechanical reflux
- Environmental toxins and mold exposure – The hidden disruptors that few consider
The Mold–GERD–Cancer Axis
One of the most underappreciated links in GERD today? Mold exposure.
In our deep dive, we show how mycotoxins from mold can:
- Suppress stomach acid
- Disrupt gut immunity and the microbiome
- Compromise detox pathways and bile flow
- Suppress immune surveillance against early cancerous changes
- Increase inflammation, oxidative stress, and epigenetic risk
This sets the stage not only for persistent GERD, but for increased cancer risk—especially in the esophagus, liver, kidneys, and hormone-sensitive tissues. Addressing mold is not fringe; it’s cancer prevention at the terrain level.
👉 Learn more:
Functional Testing for Deeper Clarity
To uncover the root causes, we recommend a blend of targeted functional labs, including:
These tests empower a clinician to treat precisely—not blindly.
Natural and Functional Supports
Rather than relying on PPIs alone, we explore a wide range of gentle, evidence-informed tools that address both symptom relief and root healing:
- HCl with pepsin – for true hypochlorhydria
- Apple cider vinegar – a gentle stomach acid primer
- Zinc carnosine – gut mucosal repair
- DGL (licorice) – esophageal soothing
- Ginger + bitters – support motility and bile flow
- Aloe vera + slippery elm – demulcents for inflammation
- Targeted probiotics – balance the microbiome and lower β-glucuronidase
- Glutathione + NAC – restore detox capacity
- Red-light therapy, adaptogens, and vagus toning – enhance systemic resilience
Environmental and Lifestyle Shifts
No GERD protocol is complete without terrain management:
- Meal hygiene – chew thoroughly, eat relaxed, avoid late-night eating
- Vagal tone – breathwork, cold exposure, singing, HRV training
- Sleep elevation – raise the head of the bed to prevent nighttime reflux
- Environmental testing – ERMI or HERTSMI-2 to assess home mold burden
- Remediation + air purification – clean air, clean gut, clean terrain
The Big Picture
GERD is not just a mechanical issue at the LES or a side effect of spicy food. It is often a signal from a disrupted system—an invitation to address:
- Your digestion
- Your nervous system
- Your microbial community
- Your detoxification resilience
- Your environment
- Your immune capacity
This is why conventional acid suppression alone often fails. The real solution lies in restoring terrain integrity, removing obstacles to healing, and reactivating the body’s ability to digest, detoxify, and defend itself.
Final Words
If you’ve tried the PPIs, adjusted your diet, and still struggle with reflux—or if your symptoms have evolved into fatigue, hormone imbalance, or even precancerous change—it’s time to look deeper.
By addressing the real reasons reflux happens, we don’t just suppress symptoms. We build resilience, reduce cancer risk, and reclaim vibrant, functional health.
