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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 using a rescue inhaler, adult-onset asthma symptoms

What Is Adult-Onset Asthma

Adult-onset asthma is asthma that first develops during adulthood, including in people who never had breathing problems as children. It may begin in someone’s 20s, 30s, 40s, or later. Like other forms of asthma, it involves inflammation and narrowing of the airways, which can cause wheezing, shortness of breath, chest tightness, and 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: Respiratory infections such as colds, flu, or pneumonia can trigger asthma symptoms or contribute to asthma first becoming apparent.
  • Allergies: Environmental allergies, whether new or longstanding, can contribute to 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: Hormonal changes, including those during pregnancy or around menopause, may influence asthma symptoms.
  • Obesity: Being overweight is a known risk factor for adult asthma.
  • Gastroesophageal Reflux: Acid reflux may worsen asthma symptoms or occur alongside asthma.
  • 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.
Man using a blue rescue inhaler outdoors while holding his chest
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. Other conditions, including COPD, acid reflux, certain vocal cord problems, and heart disease, can sometimes cause similar symptoms.
  • Spirometry: Measures how much air you can forcefully breathe out and how quickly. Testing before and after an inhaled bronchodilator can help identify reversible airway narrowing. Normal results on a single test do not necessarily rule out asthma.
  • Skin Testing: Helps identify environmental allergens, such as pollen, dust mites, animal dander, and mold, that frequently contribute to allergic asthma.
  • Blood Tests: When clinically appropriate, blood tests may provide additional information about allergic sensitivity or types of airway inflammation.
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.
Woman relaxing on a couch with arms behind her head, smiling contentedly in a bright home interior

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 and Combination Inhalers: Inhaled corticosteroids reduce airway inflammation and lower the risk of asthma flare-ups. They may be used alone or combined with a long-acting bronchodilator. Treatment is selected according to symptoms and asthma severity.
  • Leukotriene Modifiers/Inhibitors: Oral medications, such as montelukast, that block certain inflammatory chemicals. These medicines are alternatives or add-on treatments for selected patients and are generally less effective than inhaled corticosteroids for preventing flare-ups. Montelukast carries an FDA boxed warning about serious mood and behavior changes.
Reliever medications are used when symptoms occur or, for some patients, before exercise. Some modern reliever inhalers contain both a medicine that opens the airways and an inhaled corticosteroid to treat inflammation.
  • Bronchodilators: Medicines such as albuterol quickly relax airway muscles to relieve symptoms. Albuterol alone does not treat airway inflammation, which is why patients with asthma may also need an appropriate inhaled corticosteroid-containing treatment plan. Frequent need for relief medication may mean asthma is not adequately controlled.
  • Nebulizers: Devices that deliver inhaled medication as a mist. They are a delivery method rather than a separate class of medication and can be helpful for selected patients.
For adults with severe or difficult-to-control asthma, advanced therapies can be life-changing.
  • Biologic Therapies: For selected patients with moderate or severe asthma, biologic medications such as Xolair, Nucala, Fasenra, Tezspire, and Dupixent target specific immune pathways. Depending on the patient and medication, they can reduce asthma attacks and the need for oral corticosteroids.
  • SMART Therapy: SMART (Single Maintenance and Reliever Therapy) uses a specific combination inhaler containing an inhaled corticosteroid and formoterol for both daily control and relief of symptoms. For appropriately selected patients, this approach can reduce serious asthma flare-ups.
  • Immunotherapy: For appropriately selected patients with allergic asthma, allergy shots (SCIT) or sublingual immunotherapy (SLIT, including allergy drops) may help reduce sensitivity to relevant environmental allergens over time. These treatments supplement rather than replace standard asthma medications. Immunotherapy should usually not be started when asthma is uncontrolled.

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:
  • 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
Man smiling outdoors in a denim shirt with blurred trees in background

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
  • Better long-term asthma control and reduced risk of lasting loss of lung function
  • 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.
Male physician in white coat and stethoscope smiling at camera against teal background

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 experience.
  • Personalized Treatment Plans: Customized strategies based on your specific asthma type, triggers, and lifestyle.
  • Comprehensive Diagnostics: Testing including spirometry and allergy testing to help identify asthma and relevant triggers.
  • 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 tailored to each patient’s asthma and triggers.

Frequently Asked Questions

Asthma is a chronic condition without a reliable permanent cure, but many people achieve good symptom control with appropriate treatment. Some experience periods with few or no symptoms, although asthma may return. An accurate diagnosis and an individualized treatment plan can help most adults stay active.
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