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

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