
Why Is The Fentanyl Not Showing At A Higher Level In My Urine?

Question: I am a 56 year old female with severe RA, Lupus, Raynards Phenom, Graves, uncontrolled hypthyroidism, L2-L5 herniated disks, S1 nerve impingement, lower scoliosis, osteopena, severe OA both hips, THR-metal 1year ago, still suffering from pain, healing slowly, and fibromyalgia. I went back on Fentanyl Patch 100 every 48 hours, lowered breakthrough meds, oxycodone 30mg's 1 4 times a day. This has brought me down on the pain scale from a constant 8-10 to a manageable 2-3 until patch wears off. My problem is when I get a urine screen, I show very little Fentanyl in my system? I do not abuse and use as directed. I do not sweat, extremely dry skin and hair due to hypothyroidism. I had an RAUI 131 uptake in 2010. I am cold now all the time but cannot stand heat, I watch my body temp since it will go to 102 and not feel hot? Why is the Fentanyl not showing at a higher level in my urine? I have gained 40 lbs since 131 uptake, mostly around belly, before I was quite thin. I usually place on my abdomen. Should I be placing the patch elsewhere? my RA doc said could be numerous factors, metabolism, other meds, Synthroid, Crestor, Bystolic, MTX, Cymbalta, I also have Polycethemia Vera, and drink 8 to 10 bottles of water a day to keep my blood thin. I do urinate allot. But why would the Fentanyl not show a steady build up in my system since it's supposed to be put on an area of fat, and due to an adrenal tumor I release allot of cordisol so I thought the belly,fat area of my body would be best. Thank you, please advise
Brief Answer:
why concerned about fentanyl in urine
Detailed Answer:
Hi, I don't think you should be concerned about the urine fentanyl. You should consider the relief in your pain score (down from 8 to 3 in your case).
In your case as the doctor pointed out, there are lot of factors like hypothyroidism and medications for other ailments which affect fentanyl metabolism. After metabolism only the fentanyl is excreted in urine. So this is last thing you shall bother about.
Is there any other reasons why you are worried about urinary fentanyl excretion?
Regards
why concerned about fentanyl in urine
Detailed Answer:
Hi, I don't think you should be concerned about the urine fentanyl. You should consider the relief in your pain score (down from 8 to 3 in your case).
In your case as the doctor pointed out, there are lot of factors like hypothyroidism and medications for other ailments which affect fentanyl metabolism. After metabolism only the fentanyl is excreted in urine. So this is last thing you shall bother about.
Is there any other reasons why you are worried about urinary fentanyl excretion?
Regards
Above answer was peer-reviewed by :
Dr. Prasad


I never show enough of a Fentanyl build up in my system on a routine urine screen it's always been low and thought there is a federal concentration rate that should show. Same with my Synthroid.. on a blood test shows a low level. I also have a bile duct and pancreatic issue with an enzyme cy35d or something like that
Thank You
XXXX
Thank You
XXXX
Brief Answer:
hi, that s an imp enzyme.
Detailed Answer:
Hi, the enzyme you mentioned and the liver issues may lead to deranged metabolism and hence low system build up of drugs.low thyroid drugs in system are surely a concern but as long as your pain s getting relieved fentanyl levels should not worry you.
hi, that s an imp enzyme.
Detailed Answer:
Hi, the enzyme you mentioned and the liver issues may lead to deranged metabolism and hence low system build up of drugs.low thyroid drugs in system are surely a concern but as long as your pain s getting relieved fentanyl levels should not worry you.
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj

Answered by

Dr. Rohit Gulati
Pain Medicine & Palliative Care Specialist
Practicing since :1999
Answered : 252 Questions
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