Clean in the Lab, Chaotic in the Clinic: Why Steroid Selectivity Breaks Down Inside Living Patients
Engineered steroid compounds routinely demonstrate elegant receptor selectivity under controlled laboratory conditions, yet those same molecules frequently produce confounding off-target effects once they enter the complexity of a living human body. The gap between in vitro pharmacology and real-world clinical outcomes is not a minor footnote — it is one of the most consequential challenges in steroid medicine. Understanding why selectivity unravels requires a deep examination of tissue distribu