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Adult-Onset
Asthma Treatment
in San Mateo, CA

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At the Allergy and Asthma Clinic, our adult-onset asthma treatment helps patients who develop asthma later in life breathe easier and regain control of their daily activities. With over 30 years of experience, our team delivers accurate diagnosis and personalized treatment plans across our San Mateo and Daly City locations.
Table Of Contents
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What Is Adult-Onset Asthma?
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Understanding Adult Asthma Types
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Causes of Adult-Onset Asthma
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Symptoms of Adult-Onset Asthma
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Diagnosing Adult-Onset Asthma
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Treatment Options
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Who Is a Candidate for Treatment?
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Benefits of Adult Asthma Treatment
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Managing Adult Asthma Long-Term
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Cost of Asthma Treatment in San Mateo & Daly City, CA
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Take Control of Your Asthma with Expert Care
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Frequently Asked Questions
Woman in blue sweater using a blue rescue inhaler with hand on chest

What Is Adult-Onset Asthma

Adult-onset asthma is a form of asthma that first develops in adulthood, often after age 20, in people who may never have experienced breathing problems as children. Like other types of asthma, it involves chronic inflammation and narrowing of the airways, producing symptoms such as wheezing, shortness of breath, chest tightness, and persistent coughing.

Understanding Adult Asthma Types

Asthma manifests differently from person to person, and identifying your specific type is central to effective care. Adults may experience one type or a combination of several.
Triggered by allergens, such as pollen, dust mites, pet dander, or mold. Managing these allergies is key to reducing flare-ups.
Not triggered by allergens; often driven by respiratory infections, stress, cold air, irritants, or certain medications.
Develops from repeated workplace exposure to substances like chemicals, dust, gases, fumes, or animal proteins.
Symptoms such as coughing, wheezing, or shortness of breath appear during or after physical activity.

Causes of Adult-Onset Asthma

The exact causes aren’t always clear, but several factors can increase the risk of developing asthma later in life:
  • Respiratory Infections: Severe colds, flu, bronchitis, or pneumonia can damage the airways and lead to chronic inflammation.
  • Allergies: New or long-standing allergies developed in adulthood can trigger allergic asthma.
  • Environmental Factors: Exposure to tobacco smoke, air pollution, or certain chemicals.
  • Occupational Exposures: Regular contact with dusts, gases, or fumes in the workplace.
  • Hormonal Changes: Fluctuations during pregnancy, menopause, or with thyroid disorders.
  • Obesity: Being overweight is a known risk factor for adult asthma.
  • Gastroesophageal Reflux: Existing reflux conditions can contribute to symptoms.
  • Genetics: A family history of asthma or allergies increases susceptibility.
In many cases, adult-onset asthma results from a combination of these influences rather than a single cause.
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Woman coughing into her fist, a symptom of adult-onset asthma

Symptoms of Adult-Onset Asthma

Adult-onset asthma symptoms can be persistent and are sometimes mistaken for other respiratory issues. Common signs include:
  • Shortness of breath, especially during activity or at night
  • Wheezing or a whistling sound when breathing, particularly when exhaling
  • Chest tightness or pressure
  • A chronic cough, often worse at night or early morning, or after exposure to triggers
  • Frequent fatigue related to disrupted breathing
If you’re experiencing any of these symptoms, a professional evaluation can bring clarity.

Diagnosing Adult-Onset Asthma

Accurate diagnosis is the foundation of effective asthma management. Your evaluation begins with a thorough consultation, where we review your medical history, symptom patterns, potential triggers, and lifestyle factors. From there, we use targeted testing to confirm asthma, rule out other conditions, and pinpoint contributing factors. Same-day testing and treatment are available, so you can move toward relief without delay.
  • Spirometry: Measures how much air you can inhale and exhale, and how quickly, to confirm diagnosis and assess airway obstruction.
  • Exhaled Nitric Oxide (FeNO) Testing: A simple breathing test that measures airway inflammation, a hallmark of asthma.
  • Skin Prick Testing: Identifies specific environmental or food allergens triggering allergic asthma.
  • Blood Tests: Check for specific IgE antibodies to further pinpoint allergic sensitivities.
Ongoing monitoring lets us track how your lungs respond to treatment, confirm your medications are working, catch early signs of worsening inflammation, and prevent flare-ups before they escalate. This proactive approach means your care evolves as circumstances, seasons, and triggers change.
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Treatment Options

There is no single approach to treating adult-onset asthma. Because the condition presents differently in each person, we design personalized plans that combine several therapies to reduce inflammation, control symptoms, minimize flare-ups, and help you breathe with confidence. Treatment typically follows a layered strategy – daily preventive medications, quick-relief options for acute symptoms, and, when appropriate, advanced therapies.
Taken regularly to reduce airway inflammation and prevent symptoms before they start.
  • Inhaled Corticosteroids: Anti-inflammatory medications that reduce airway swelling and mucus production. They usually take several weeks to reach full effect and to prevent attacks rather than to stop one in progress. Examples include Flovent, Pulmicort, Asmanex, and Qvar.
  • Leukotriene Modifiers/Inhibitors: Oral pills that block inflammatory chemicals to prevent symptoms without steroids. Examples include Accolate, Singulair, and Zyflo.
Also known as “rescue” medications, used to quickly open the airways during an attack or before exercise.
  • Bronchodilators: Relax the muscles around the airways to open them quickly, including beta-agonists and anticholinergics. They relieve symptoms but don’t address underlying inflammation. Needing a rescue inhaler more than a few times a week may signal worsening inflammation – talk with your provider about adjusting your plan.
  • Nebulizers: Deliver medication as a fine, easy-to-breathe mist, offering an effective option for some patients.
For adults with severe or difficult-to-control asthma, advanced therapies can be life-changing.
  • Biologic Therapies: Medications such as Xolair, Nucala, Fasenra, Tezspire, and Dupixent target specific immune pathways that drive chronic respiratory inflammation. By addressing the root cause, they can prevent severe attacks, reduce the need for oral steroids, increase activity levels, and improve quality of life.
  • SMART Therapy: Single Maintenance and Reliever Therapy uses one inhaler for both daily control and symptom relief, streamlining treatment.
  • Immunotherapy: For allergic asthma, allergy shots or sublingual immunotherapy (allergy drops) help desensitize the immune system to specific allergens for long-term relief and reduced medication needs.
  • Accurate diagnosis of their respiratory symptoms
  • Effective management strategies to control asthma
  • Reduced frequency and severity of asthma attacks
  • Improved lung function and quality of life
  • Personalized care tailored to their unique triggers and lifestyle

Who Is a Candidate for Treatment?

You may be a candidate if you’re experiencing persistent shortness of breath, wheezing, chest tightness, or a chronic cough that developed in adulthood. Candidates also include adults whose symptoms interfere with sleep, exercise, or work, and those who rely frequently on a rescue inhaler. Ideal candidates are looking for:
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Benefits of Adult Asthma Treatment

Effective treatment does more than ease breathing – it restores your ability to live fully. Patients who commit to a personalized plan often experience:
  • Improved breathing and clearer airways for greater daily comfort
  • Fewer and less severe asthma flare-ups
  • Reduced wheezing, coughing, and shortness of breath
  • Better sleep and reduced nighttime symptoms
  • Greater freedom to exercise and stay active
  • Reduced reliance on rescue inhalers
  • Lower risk of emergency room visits and hospitalizations
  • Long-term lung health and protection against irreversible damage
  • Renewed confidence in managing daily life

Managing Adult Asthma Long-Term

Asthma is a chronic condition, and lasting success comes from ongoing partnership. Long-term management includes:
Consistently taking prescribed medications and following recommended therapies.
Minimizing exposure to your personal asthma triggers.
Routine follow-ups and lung function tests to track progress and adjust care.
A clear plan for managing symptoms, medications, and what to do during a flare-up.
Healthy habits such as a balanced diet, regular exercise, and avoiding smoking.
Our team works alongside you to keep your asthma well-controlled year after year – helping you stay ahead of symptoms rather than simply reacting to them.

Cost of Asthma Treatment in San Mateo & Daly City, CA

The cost of adult-onset asthma treatment in San Mateo and Daly City varies, depending on the diagnostic testing, medications, and therapies your plan requires. We accept most insurance plans, including Aetna, Anthem, Blue Cross Blue Shield, Cigna, UnitedHealthcare, UMR, Guardian, Health Net, Medicare, Great-West Healthcare, MultiPlan, PHCS, SEQUOIA, and TRICARE.
Contact our team for a personalized quote tailored to your needs.
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Take Control of Your Asthma with Expert Care

Our practice brings together decades of expertise and a genuinely personalized approach:
  • Decades of Experience: An expert team with over 30 years of combined experience.
  • Personalized Treatment Plans: Customized strategies tailored to your specific triggers, symptoms, and lifestyle.
  • Comprehensive Diagnostics: Advanced testing including spirometry, FeNO, and allergy testing to pinpoint the nature of your asthma.
  • Advanced Therapeutic Options: A full range of daily controllers, quick-relief medications, and advanced biologic therapies.
  • Flexible Financial Solutions: Most insurance plans accepted, plus customized and monthly payment plans with low interest rates for those without insurance.
  • Convenient Care: Same-day testing and treatment, both virtual and in-person appointments, and two Bay Area locations in San Mateo and Daly City.
Our long-standing reputation in the Bay Area reflects our commitment to precise diagnosis, evidence-based treatment, and care that treats the root of your asthma – not just the symptoms.

Frequently Asked Questions

Asthma is a chronic condition without a permanent cure, but it is highly manageable. With an accurate diagnosis and a personalized treatment plan, most adults control their symptoms effectively and maintain an active lifestyle.
Common triggers include respiratory infections, allergens like pollen and dust mites, irritants such as smoke and pollution, occupational exposures, and even stress or certain medications. Identifying your specific triggers is a key part of your treatment plan.
Frequency depends on the severity of your asthma and how well it’s controlled. You may have more frequent appointments initially for diagnosis and adjustments, then regular follow-ups every few months once stable.
Yes. We accept both virtual and in-person appointments to make care as convenient as possible.
Scheduling is quick and takes just 5–10 minutes by phone or online. Call us or fill out a short form on our website to book your consultation.

Ready to Breathe Easier?

Take the first step toward better breathing and lasting control of your asthma. Our team is here to help you find relief.
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Types of Asthma
Testing for Asthma
Asthma Treatments
Allergies

Food Allergies

Insect Allergies

Environmental Allergies

Skin allergies

Other CommonAllergies

Nose & Sinus Allergies

Allergies Testing
Allergic Treatments

Allergy Shots

Allergy Drops

Allergy Medications

Lifestyle Changes

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First and foremost let me start by saying that these people did one hell of a job figuring out my sinus problems. When I first arrived there, I explained what was going on with me having excessive inflammation in the sinus…after they tested me, I found out that I was being exposed to dust mites which gave me a strong reaction. I followed the doctors guides lines in terms of cleaning my room and ever since, my sinus inflammation went away for good and now I have a healthy sinus. Thank you for everything.

- Johnathon T
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Dr. Engler is great and his staff, both medical and administrative, are wonderful. Dr. Engler is competent, caring, and listens better than any doctor I’ve ever had, constantly and patiently asking if I have any more questions. The staff is great. The nurses are very friendly and helpful. The desk staff is the same. I have been going here over a year and have always received caring and competent treatment. I highly recommend them.
- Tom B
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Hands down the best place to go for Allergies and Asthma. The staff is incredibly kind and caring and so professional and helpful. I’ve been going here for over 30 years and they have gone out of their way countless times to make sure that I was well-cared-for. The nurses are excellent and always make sure to ask how my family is doing not to mention that they give the most painless allergy shots around. They remember little details about me and always make sure to give me a lollipop for my son, even when he’s not with me. Brooke is a great diagnostician and listener and each time I have an appointment with her, I always leave feeling better. The same is true for Dr. Engler.

My 10 year old son also has allergies and asthma and the staff makes sure that he feels well taken care of and comfortable, despite his having Autism and ADHD. He actually looks forward to going there with me, whether it be for my allergy shots or even when he needed allergy skin testing. When you’re a patient at the Allergy and Asthma clinic, you are treated as if you are the only patient they have, even when the waiting room is full. Dr. Engler has hired truly excellent staff, from the front desk people to the nurses and medical assistants. If you have allergies and/or asthma and you live on the Peninsula or even in the city, I highly recommend that you visit the Allergy and Asthma Clinic. They are truly amazing and will make you feel so much better.

-Sandi S.
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I had an amazing experience at this clinic. Dr. Engler and the staff were all extremely welcoming, warm, and thorough in their various lanes of work from the front desk to billing to the assistants to Dr. Engler himself.
One thing I wish I knew before coming in was that the food test covers 80 allergens, and the environmental test covers 80 allergens meaning if you want to do both you need to come two separate days. This is kind of a hassle but definitely worth it since you’ll be tested for 160 allergens whereas most clinics only test 80 total.
Through the tests I figured out what I was allergic to and was advised to use an over the counter medication which has drastically helped and eliminated the symptoms I was experiencing. Dr. Engler also covered all the things I needed to do to reduce my symptoms via my lifestyle which was super helpful with my symptom reduction as well. I’d highly recommend this clinic! Insurance covered the tests and visits. (I have anthem blue cross)
-Christina L
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I’ve been a patient at The Allergy and Asthma Clinic for over 12 years, and I can’t speak highly enough of the care I’ve received. Growing up with severe pollen allergies, I’ve been on and off allergy shots for years, and this clinic has truly been a lifesaver for me.
From the moment you walk in, you’re treated like family. The staff is incredibly kind, caring, and genuinely invested in your well-being. I have never had a negative experience with anyone here; everyone is consistently friendly and supportive.
Dr. Engler is exceptional! He has a remarkable ability to quickly and effectively address any situation. His expertise and compassionate approach have made a significant difference in managing my allergies.
If you’re struggling with allergies or asthma, this is the place to go. I wholeheartedly recommend The Allergy and Asthma Clinic to anyone seeking top-notch care.
-Trevor C