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By the time the first symptoms of Alzheimer’s disease show up, how much damage has the brain sustained?

By the time the first symptoms of Alzheimer's disease show up, how much damage has the brain susta… by Steven Fowkes

Answer by Steven Fowkes:

I’m going to disagree with most of the experts so far. I think the answer is “minimal.”

Let me begin to qualify that by stating that there is much accumulated metabolic damage before onset of symptoms. The brain’s energy systems have been seriously down-regulated over years if not decades. Redox-control systems (NADH>>NADPH>>GSH>>ascorbate) have gotten weaker. There may be vascular changes. There are likely cell-population changes. And certainly there is a deepening and widespread edema of the brain. But I do not consider these “damage” in the sense of irreversibility. I think the connotation of damage is loss of brain cells.

I consider the “onset” of Alzheimer’s disease to be the specific metabolic changes of the Alzheimer’s “cascade failure” and NOT the predisposing factors that led up to the cascade. In other words, insulin resistance is a causal mechanism for Alzheimer’s disease, but it is not an essential mechanism; you can have Alzheimer’s disease without having high insulin resistance. Dale Bredesen now recognizes five types of Alzheimer’s disease, each of which has a different contribution from the many predisposing factors. But the onset of Alzheimer’s disease DOES have a metabolic signature that is essential (i.e., common to ALL Alzheimer’s diseases).

So I consider that essential metabolic cascade to be the actual onset of to Alzheimer’s disease. I doubt that this is the case for other answers.

Let me point out one aspect of Alzheimer’s disease that is frequently misinterpreted as “brain damage” and “loss of neurons” that is really just edema. Brain images of people with Alzheimer’s disease and other dementias (and neither) can show shrinkage of the brain and fluid accumulation around the brain. This can be interpreted as brain shrinkage from loss of neurons. I have had several clients who were told this. Literally. Even though it COULD be from loss of neurons, it is far more likely not. When metabolic rate is raised, the brain absorbs the fluid and expands to fill the skull again. If the shrinkage of the brain can be reversed in days, it is NOT a sign of cumulative neuronal death.

In other words, I do not consider brain edema to be damage. It is temporary. It is easily reversible. It is non-essential.

There are other answers on Quora (and a video series on YouTube) where I have gone into more depth on the essential metabolic disturbance of Alzheimer’s disease, so I’ll only summarize it here: it is the systematic loss of sulfhydryl-containing enzyme activity in the brain. In Alzheimer’s disease, the sulfhydryl-containing enzymes are decimated, and non-sulfhydryl enzymes are minimally affected or collaterally affected.

So, in answer to your question, the amount of neuronal death prior to (1) the loss of sulfhydryl enzyme activity, (2) the loss of microtubule-based axonal and dendritic transport, (3) the loss of creatine phosphate back-up energy reserves, and (4) the loss of the 90-second phosphorylation rhythm (phosphorylase-phosphatase cycling) is minimally different from any other normative disease of aging. In other words, if Alzheimer’s disease is rapidly reversed within weeks of onset, the loss of cognitive capabilities will be trivial.

Now that Alzheimer’s disease reversal is becoming mainstream at a research level, we will have the opportunity to test this hypothesis.

I hope this provides a different perspective than other answers.

By the time the first symptoms of Alzheimer's disease show up, how much damage has the brain sustained?


What are the best ways to increase traffic to a Personal Blog?

What are the best ways to increase traffic to a Personal Blog? by Ivan Filimonov

Answer by Ivan Filimonov:

First, you find interesting trending topics related to your business/niche/products/services.

There are several ways doing that effectively. I suggest you run all of them and compile all the data you’ll gather and then analyze it.

1. Research content in your niche and explore good ideas with Alltop. Here you can research trending posts in subtopics that you will target:


Google loves good answers to niche-specific questions. It includes the best answers in rich snippets.

This is also a great source of finding what other related questions are searched for, which might give you great ideas on what type of content to do next.

Stepping even further into this, you can use Search Suggestion services like Answerthepublic or

Here’s what you’ll get from Answerthepublic for the “how to make omelette” query:

24 questions related to the keyword. Some might be useful.

To maximize your search suggestion research, use “Questions Only” tool in Sersptat’s Search Suggestion report:

It’s the most efficient way to research suggestions with your queried keywords. It also has the biggest database for them. Our sample “how to make omelette” keyword showed 208 related questions. Let’s take a brief look at some of these:

I mean, I’m vegan, but still found some of these recipes interesting (it caught my attention for a sec, at least:)).

Bottom line: give good answers for these and you’ll see results faster as search suggestions are essentially the micro-volume searches that users ask themselves, especially mobile users.


One of the most under-estimated report in Sersptat’s arsenal, Top Pages – shows you all the pages with the highest visibility for a cluster of keywords (not just your queries keyword but all LSI search terms to boot):

It also gives you the ability to sort the list of top pages by number of social shares to spot viral content. Research these pages to find out what makes them a tick.

  • Find top performing blogs in your niche using Top Pages report.
  • Run each blog through the tool (simply type in domains to the search box as it’s both for keywords, domains and URLs) and find their 10 top performing pages with this same report:
  • Do it with the 10 prominent blogs and you’ll have 100 MOST trending topics in your niche.
  • Combine that with Search Suggestions, and you’ll have your content plan for a year at least!

What are the best ways to increase traffic to a Personal Blog?

Vasculogenesis Vs Angiogenesis

So at first, I thought that Angiogenesis referred to any new development of blood vessels in the body. But scientific terms make a specific distinctions in what words mean.

Angiogenesis is the formation of new blood vessels from pre-existing ones.

But Vasculogenesis is the formation of new blood vessels when there are no pre-existing ones.

Is Lasik worth the money or should I continue using contact lenses and glasses?

Is Lasik worth the money or should I continue using contact lenses and glasses? by @endmyopia

Answer by Jake Steiner:

LASIK. Be careful. Very, very careful.

The surgeons and clinics won’t tell you anything about the dark side of LASIK.

That’s your eyeball.

Let’s look at your question. Read this whole post. You might be saving your eyes by taking just a few minutes of time right now!

I’ll comment on this since I get so, so, so many emails about people who did LASIK and regretted it. I will try not to be entirely biased here, just based on all the sad stories I’ve read.

Take a few days to learn some vision biology basics. Read a few studies about myopia. And very, very carefully valuate your options before diving into surgery.


Why Do You Have Myopia?

Learn about how your eyes actually work and what causes myopia (The Eye & Myopia). You could be surprised to find out that the stimulus that caused your increasing myopia is actually the focal plane change from your glasses. LASIK will have the same exact effect, and if your myopia is still progressive then you may continue to become more myopic.

Retail optometry isn’t the same as optometry science, and the people you trusted with treatments just sold you higher and higher diopter glasses. All that’s reversible potentially, but do you want to trust those same people with more advice for your eyesight?

Maybe you do. All I’m saying is, ask some questions. Start being curious.

Go to and search for “lens induced myopia” and “hyperopic defocus” and “pseudomyopia” and “near induced transient myopia”. A whole lot of studies that might make you go hmmmmmm.

Teaser: Minus lenses (and LASIK) create hyperopic defocus while you’re focused up-close. If that’s confusing, you’ll want to take a step back and learn about it, not just click away and go back to the LASIK brochure.

Maybe. Up to you.

Meanwhile here’s what happening to your eyesight with lenses in front of them:

LASIK is no different from glasses, in that respect. It just hides the symptom, possibly temporarily. Do some research before committing to irreversible surgery.


Careful Who You Listen To For Unbiased Advice.

LASIK is a product.

Yes, “surgeons”. That’s nice. Does that mean you should blindly (heh) trust them?

The fact is, they’re running a business, a business designed to make money, and you are a prospective customer. Separate the idea of “doctors” and “medicine” from the fact that you’re dealing with a business, and somebody being extremely biased trying to sell you their product and make money.

Think about this carefully. Remember that the surgery is irreversible.

And realize that LASIK has its share of sketchy skeletons in its closet:

Yikes. Go dig, go research, before getting surgery!

Again, I’m not saying you should stick with contact lenses and glasses necessarily. I’m saying, just do your research. Hear both sides of the story, not just the LASIK sellers.

And third:

LASIK can have serious and permanent side effects.

Google FDA and their statistics on LASIK problems. The FDA’s own website (!) shows statistics of very serious and very irreversible problems with LAISK. That should give you pause, and really help you to think about whether this is a great idea.

Maybe it is. Many people love the procedure.

The problem is that if you don’t, the things that can go wrong can’t ever be undone. And glasses in hindsight will seem like a benign option.

Lisa: Did LASIK, Got Warped Cornea – this and countless other stories, on

Research and evaluate.

Does this look like a reasonable option to deal with your myopia?

It’s your eyes. You’ll have to decide whether to remain blissfully ignorant and buy more products to hide the problem.

Choose whether you want to trust the people making money selling you a product dressed up as “medical” advice. Use Google, do research, don’t be swayed by the pretty testimonials alone. Always keep in mind that the surgery is *permanent*, including potential side effects.

Lots more LASIK related posts, reviews, science and ideas, here: LASIK (Side Effects & Topics)

And upvote this post if you appreciate the suggestions. 😉

Is Lasik worth the money or should I continue using contact lenses and glasses?

What hinders scientists from discovering a cure for HIV/aids?

What hinders scientists from discovering a cure for HIV/aids? by Christopher VanLang

Answer by Christopher VanLang:


HIV is a legitimately difficult problem. Thousands of very smart people have devoted the last 30 years studying every gene, protein, molecule in the virus and have created more models than any disease other than cancer. I spend two hours sitting with an undergrad who asked me “well… why didn’t they try [X] then?” and I had an answer ready for them. Nearly everything has been tried against HIV and unless people people invent a class of drugs (which does happen on periodic basis), our current tools aren’t going to work.

People have to recognize what HIV is. It’s an lipid encapsulated ss-RNA retrovirus that works by invading the T-Cells, the very cells that our immune system relies on to response to viral infections.

There is one and only one viral protein target on the outside and that is the env protein which is a bitch of a protein to target. It’s coated with sugars and the only conversed domains are hidden in the core. Antibody responses rarely block a meaningful site on the protein. In a cohort study of 4,484 patients selected from a pool of 18,489 individuals, only 239 generated antibodies that did anything. Of that group, only 19 produced antibodies against the GP41 domain.  [1]

The structure of this protein is coated with glycans (shown in green) which protect the protein. Only when the env protein is bound to its target of CD-4, do the conversed regions exposed themselves (in white). Targeting HIV is like waiting until a suicide bomber to take out the trigger to identify the bad guy.

That’s assuming that we can even find the virus in the first place. HIV can lie dormant in reservoirs in CD4+ T-cells for decades and patients who have no signs of HIV for years can suddenly have an outbreak of the virus. Only 1 in 1 million T-Cells will contain latent HIV.

In summary, finding an actual cure for HIV is a bitch. Believe me, people have tried. But until someone comes up with a special nanobot that can individually search through 1 million T-cells, pull out the virus and then bind to the one conserved spot on the bug, we’re not going to get a “cure” for a while.

But that’s not going to stop people from trying. See the answers over at What are the most promising treatments in development for HIV?



What hinders scientists from discovering a cure for HIV/aids?

What is it like to be a trained martial artist and have an untrained person on the street want to fight you?

What is it like to be a trained martial artist and have an untrained person on the street want … by @Tao_Of_Violence

Answer by Martyn V. Halm:

"What is it like to be a trained martial artist and have an untrained person on the street want to fight you?"

Before I was a 'trained martial artist', I was a 'trained/experienced' street brawler and nightclub bouncer. Bouncers get challenged all the time, mostly by dickheads who want to prove their manhood.

I was on my break, standing outside drinking from a bottle, when an asshole (who I had confronted over cocaine use earlier) exited the club and noticed me. He and two of his friends walked up to me, so I lowered my bottle to my side. They stood in front of me in a semi-circle and the leader said, "I guess you don't feel so tough now."

"Unlike you," I said, "I don't need other people to prop up my ego."

That riled him into action. As he jabbed his finger at my chest, I buried the neck of the bottle in the armpit of his outstretched arm*. He turned green, dropped to his knees and started vomiting, and his friends stepped away as I walked around them and went back into the club.

Brutal action, I know, but I don't really care about being gentle with loudmouth idiots who try to intimidate me to show off to their friends about their alpha male status.

Addendum: This proved to be one of my more popular answers, but it also generated some questions that can be found in the comments. I'm just answering some of the more salient points here:

Why did the guy puke? Was the bottle to the armpit really that painful?

The armpit has a cluster of nerve endings and some main arteries going through it. If you want to experiment, jab a finger into your own armpit.

I'll wait.

Did you do it? Hurts, right?

Now, imagine the neck of a beer bottle being rammed violently into that tender spot. The pain and shock is unbelievable, and can induce paralysis of the arm and vomiting from the pain.

Is the paralysis permanent or temporary?

Depends on the force of penetration and the object shoved into the armpit. If you ram stiff fingers in an armpit that's covered by a leather coat, the numbness in the arm may take 15-30 minutes to abate.

With regards to my situation, he was wearing a suit jacket and T-shirt (Miami Vice Sonny Crocket Wannabe) and I used a glass bottleneck, which accounts for the pain being so immense that it induced intense nausea and vomiting. His arm wouldn't regain full function for a few days and his armpit would most likely have been sore for a week or more.

This is a dangerous technique – especially if you ram the bottle in the left armpit, like I did – because the shock and pain can reach the heart and cause arrhythmia, from which a person could die (depending on age and general health, of course). If you'd do it on someone wearing only a T-shirt, a stiff thumb would have an immediate effect without running the risk of accidentally killing someone.

*The exact spot where I hit him is the subscapularis (the red part):

The subscapularis muscle is part of the rotator cuff. Bruising/damaging this muscle will make it difficult (if not impossible) to raise the elbow at the same height as the shoulder.

This part of the axilla (latin for armpit), also contains a major artery (just under your scapula or shoulder blade) and a whole slew of lymph nodes. In short, this is a major cluster of lymph nodes, major blood vessels, and nerves, overlaid by a rotator cuff muscle that will disable your arm when it's hurt.

Some people seem to doubt that a simple blow to the armpit could be vomit and paralysis inducing and might even kill someone. The fact that in duelling times people used daggers and rapiers on the armpit to kill someone was mostly due to the fact that people wore armour protecting other vulnerable bits, but the armpit is difficult to protect, so it makes for an excellent target.

What is it like to be a trained martial artist and have an untrained person on the street want to fight you?

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