Fish Allergy Treatment
in San Mateo, CA

The Allergy & Asthma Clinic offers specialized treatment for fish allergies, grounded in decades of clinical experience and meticulous patient monitoring. The immune system response can vary widely between individuals, requiring ongoing assessment and adjustment. Therefore, treatment at our clinic is not a one-time fix but a continuous process tailored to how the body adapts over time. We are dedicated to managing allergies with precision and attentiveness, aiming to give patients confidence and improve their well-being.  
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What Is a Fish
Allergy?

A fish allergy is a condition in which the immune system reacts abnormally to proteins found in certain types of fish. Instead of recognizing these proteins as harmless, the immune system mistakenly identifies them as a threat and triggers a defensive response. This reaction can affect various parts of the body, even though fish is otherwise a nutritious food. Fish allergies can develop at any age and may persist throughout life. It is essential to understand that this allergy involves the immune system’s specific sensitivity to fish proteins, not a general intolerance or digestive issue.
Symptoms of Fish Allergy
  • Skin reactions such as itching or hives
  • Swelling of the lips, face, or throat
  • Stomach pain, nausea, or vomiting
  • Difficulty breathing or wheezing
  • Dizziness or lightheadedness

What to Expect During an Appointment

Physical Examination

During your appointment, our doctor will begin with a detailed review of your medical history and any past allergic reactions. We will then perform a physical examination to look for signs that may support the presence of an allergy. This helps rule out other possible causes and guides the next steps in testing and treatment.
To confirm a diagnosis, we may recommend a combination of tests such as a skin prick test, a blood test, or, in some cases, supervised oral food challenges. These methods help determine how your immune system responds to specific fish proteins. Your results will be thoroughly reviewed to ensure an accurate diagnosis and to guide your treatment plan.
Based on your test results and personal needs, our experienced allergist will create a customized treatment plan specifically tailored to you. This may include medication to manage reactions or prevent future symptoms. Our goal is to ensure that every person receives care that fits their lifestyle and health goals.
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Fish Allergy Treatments

Avoidance

The most effective way to manage a fish allergy is to avoid the allergen completely. This includes carefully reading food labels, asking about ingredients when dining out, and staying informed about hidden sources of fish in sauces, broths, or processed foods. Avoidance requires vigilance and preparation, but it plays a central role in preventing allergic reactions.

For individuals at risk of severe allergic reactions, carrying an epinephrine auto-injector or nasal spray is essential. This emergency medication works quickly to reverse life-threatening symptoms and should be administered immediately after exposure to fish. We help patients develop a Food Allergy Action Plan with clear instructions on what to do in the event of accidental exposure.

Oral immunotherapy (OIT) involves gradually introducing small amounts of fish protein in increasing doses to build the body’s tolerance over time. While it can be effective for some individuals, OIT carries the risk of allergic reactions during treatment and often requires a long-term commitment to daily dosing and strict food avoidance outside of therapy.
XOLAIR (omalizumab) is an FDA-approved treatment that offers a promising option for many individuals with fish allergies, especially those at risk for severe or life-threatening reactions. Unlike oral immunotherapy, which targets only one specific allergen, XOLAIR works by blocking IgE—the antibody responsible for triggering allergic responses—providing broad protection against multiple food allergens, including fish. It is administered via injection and has been shown to reduce the severity of allergic reactions and lower the likelihood of anaphylaxis in the event of accidental exposure. XOLAIR is generally well-tolerated, with fewer side effects than OIT, and it begins working within weeks rather than months. Thus, this mediation is very helpful in treating food allergies.
Sublingual immunotherapy is a non-invasive treatment that delivers tiny doses of an allergen under the tongue to help desensitize the immune system over time. It may be considered for patients with milder sensitivities or as an alternative for those who prefer a less intensive approach than OIT.
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How Long Does It
Take to Treat a Fish
Allergy?

Treating a fish allergy is often a long-term process aimed at reducing sensitivity and preventing severe reactions. For many individuals, strict avoidance remains necessary indefinitely, especially when the allergy is severe. However, emerging treatments like immunotherapy may offer the possibility of gradually training the immune system to tolerate small amounts of fish protein. In some cases, individuals may eventually be able to eat certain types of fish, but this varies widely based on the person’s response to treatment. Ongoing care and regular evaluations are crucial for monitoring progress and adjusting the plan as needed.

Candidates for Fish Allergy Treatment

Fish allergy treatment can be considered for a wide range of individuals who are managing allergic reactions to fish. Whether symptoms are mild or severe, identifying appropriate candidates is the first step toward developing a personalized care plan. Our treatments can benefit:

  • Patients diagnosed with a confirmed fish allergy
  • People experiencing ongoing allergic reactions to fish
  • Individuals with a family history of seafood allergies
  • Patients with anxiety related to accidental exposure
  • Those who have previously experienced anaphylaxis from fish
  • People seeking evaluation after a recent allergic episode
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Benefits of Fish
Allergy Treatment

Fish allergy treatment can offer meaningful improvements for individuals managing the challenges of living with a food allergy. With the right approach, many patients find it easier to navigate daily life and feel more in control of their health. Our patients may experience the following benefits:

  • Reduced risk of severe allergic reactions
  • Increased confidence when eating outside the home
  • Relief from constant worry about hidden ingredients
  • Improved quality of life through greater dietary freedom
  • Fewer disruptions to travel, school, or social activities
  • Better long-term allergy management strategies

Cost of Fish Allergy
Treatment in San
Mateo, CA

The cost of fish allergy treatment in San Mateo, CA, can vary widely depending on several factors. These include whether allergy testing or treatment is covered by insurance, the specific type of tests used (such as skin prick or blood tests), fees charged by the provider, and any follow-up services required.
Schedule a consultation at the Allergy & Asthma Clinic today! Dr. Engler and his team will assess your symptoms and develop a personalized treatment plan for your specific needs.
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What Makes Our
Allergy Treatments
Different From
Others?

The Allergy & Asthma Clinic approaches fish allergy treatment with a focus on long-term care and understanding how the immune system interacts with the body. Patients return on a regular basis to ensure their treatment remains effective and is adjusted as needed. Our clinic combines expert knowledge with the latest treatments in allergy medicine to support each person’s unique needs. This consistent, thoughtful approach helps reduce anxiety and builds confidence in managing the allergy over time.

Frequently Asked Questions

Can patients have multiple food allergies?
Yes, it is common for patients to have more than one food allergy. Many individuals diagnosed with a fish allergy may also be allergic to other foods, such as shellfish, nuts, or eggs. Understanding the full range of allergies helps guide safe management and treatment.
Accidental exposure to allergens can be dangerous, especially for those with fish, milk, peanut, tree nut, and shellfish allergies, which are known to cause severe reactions. Additionally, environmental allergens such as pollen and mold can sometimes exacerbate overall allergy symptoms, increasing sensitivity. It is essential to take precautions to avoid exposure whenever possible.
If a severe reaction occurs before a scheduled visit, it is crucial to seek emergency medical attention immediately. Using prescribed emergency medications, such as epinephrine, can be life-saving. After stabilizing, patients should inform the clinic and schedule a follow-up visit for further evaluation.
Allergy shots are not commonly used to treat fish allergies at this time. Treatment typically focuses on avoidance and emergency preparedness. Other specialized therapies may be considered on a case-by-case basis.
Yes, patients from across the San Francisco Bay Area, including those from Menlo Park, San Jose, and Oakland, are welcome at our locations in San Mateo and Daly City. Our clinic serves a broad community with comprehensive allergy care.

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
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
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.
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
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