Inflammation is a natural and necessary part of healing, but when it persists, it becomes part of the problem. Acute inflammation is the body’s frontline defence; a short-term response to injury or infection. The immune system activates, clears the threat, and returns to its baseline status once healing begins.

Chronic inflammation, however, is different. It’s subtle, longer-lasting, and often driven by modern lifestyle habits rather than injury. Dr Hisham, General Practitioner and Longevity Medicine Physician, points out that in Singapore, chronic inflammation is frequently linked to factors like poor sleep, processed food consumption, mental stress, and elevated visceral fat. As a result, the immune system remains “stuck on low gear”, releasing inflammatory signals continuously. Over time, this persistent inflammation can damage tissues, disrupt hormone function, accelerate ageing, and increase the risk of conditions like diabetes, heart disease, and even dementia. Unlike acute inflammation, chronic inflammation is often subtle but can have widespread effects.

Diagnosing chronic inflammation presents unique challenges, as its symptoms are often subtle or not immediately apparent. A person may feel “fine” or be productive, yet underlying inflammation could still be placing stress on the body.

In Singapore, one particular challenge is the limited availability of advanced inflammatory markers, such as TNF-alpha or IL-6, in routine settings. However, these markers are not necessary for diagnosing chronic inflammation. Instead, healthcare providers can use a range of locally biomarkers to assess its presence and severity.

In my practice, I combine these biomarkers with a patient’s medical history and lifestyle context to form a comprehensive picture of chronic inflammation. Some of the key biomarkers I rely on include:

• hs-CRP: A sensitive marker for low-grade inflammation.
• Ferritin: Although typically associated with iron, ferritin levels can also rise in response to inflammation.
• Homocysteine: This marker reflects oxidative stress and vascular health.

This key lies in analysing the trends and patterns formed by these biomarkers, which requires the expertise of a physician experienced in longevity.

For individuals at risk of chronic inflammation due to genetics or environmental factors, it’s crucial to take action before symptoms appear. As Dr Hisham notes, if you have a family history of cardiovascular, metabolic, or autoimmune diseases, chronic inflammation can begin years before a formal diagnosis.

In places like Singapore, where long hours, high stress, late nights, and processed foods are common. Dr Hisham recommends basic biomarker screenings for adults as early as their 20s and 30s, particularly for those with a family history or lifestyle risks. These include:

• hs-CRP
• Ferritin, GGT, and homocysteine
• Omega-3 and omega-6 fatty acid levels
• Fasting insulin and lipid profile
• Vitamin D levels
• Visceral fat assessment
• Lifestyle review: Sleep, diet, physical activity, and stress levels

Early intervention goes beyond blood tests. It’s about establishing daily habits that help restore balance in your body; which serves as the foundation for long-term health.

When it comes to chronic inflammation, Dr Hisham emphasises that he doesn’t believe in blunt-force approaches. The goal isn’t to shut the system down but to restore its rhythm, calm the excess activity, and allow the immune system to regulate itself once again.

He takes a layered approach to managing chronic inflammation:

Foundation:

• Anti-inflammatory nutrition: Emphasising more plant-based foods, healthy fats, and fewer ultra-processed foods.
• Correcting the omega-3 to omega-6 ratio: Ensuring a balanced intake of these essential fatty acids to support inflammation regulation.
• Replenishing vitamin D: Ensuring adequate levels for immune health.
• Targeted supplements: Using compounds like curcumin, magnesium, and polyphenols to support the body’s inflammatory response.
• Physical movement: Encouraging low-intensity daily activities, such as walking or zone 2 cardio, which involves moderate-intensity aerobic exercise where your heart rate stays between 60-70% of your maximum. This type of exercise promotes overall health and helps reduce inflammation.
• Adequate, high-quality sleep: Sleep is essential for immune function and inflammation management.
• Meditation and stress management: Techniques like mindfulness help calm the nervous system and support immune balance.

Advanced tools for certain patients:

• Red light therapy, sauna, and cold exposure: These therapies offer gentle hermetic stress, which can help retrain the immune system and promote recovery.
• Senolytics: Nutrients that may aid in clearing ageing “zombie” cells, which can contribute to chronic inflammation.
• Gut restoration: Particularly important in inflammation is gut-driven, as gut health plays a significant role in overall inflammation.
• Biologics: For autoimmune conditions or severe inflammation, Dr Hisham often works with and refers to other medical specialists to manage these treatments effectively.

Stress reduction techniques like meditation or mindfulness can indeed have a significant effect on chronic inflammation, though it’s something we often overlook in fast-paced environments like ours. Chronic stress acts as a catalyst for inflammation. It disrupts cortisol rhythms, affects gut health, interferes with sleep, and pushes the immune system into overdrive. While we may not measure stress hormones daily in the clinic, the effects are clear: poor recovery, recurrent infections, brain fog, and unexplained weight gain, particularly around the abdomen.

Dr Hisham suggests, mindfulness practices such as meditation, deep breathing , prayer, or moments of silence, help shift the body out of “survival mode.” They activate the vagus nerve, calm the sympathetic nervous system, and support immune regulation.

In my clinic, I recommend these techniques just as I would medications or supplements. Personally, I practice meditation for 30 minutes each day.