Dried Blood Spot (DBS) Testing | LC-MS/MS Analysis

Q: Do DBS samples require refrigeration or a cold chain?

No. DBS cards can be transported and stored at room temperature using standard postal services without any special cooling requirements. We always recommend placing the dried card in a resealable bag with a desiccant sachet before shipping. No dry ice, no refrigerated courier, no special handling required.

The dried blood spot (DBS) is a technique that is an alternative to conventional venipucture blood collection for clinical testing. The collection process involves a fingertip or heel (in the case of newborns and infants weighing less than 10 kg) prick and blotting the capillary blood onto a filter paper. The puncture is performed using a disposable pricker. Then blood collected on the filter paper is dried at room temperature in a horizontal position for approximately 2-3 hours. The DBS sample prepared in this way can be transported or used directly for diagnostic tests.

Unique properties of dried blood spot

Low invasiveness:
Capillary blood collection is a convenient method of obtaining material for diagnostic tests in children, seniors, obese individuals, intellectually disabled individuals, as well as those who experience fear of needles.
It provides a good solution when it is very difficult to perform an intravenous puncture due to problems with finding veins.
In addition, obtaining blood from the fingertip may be advisable for individuals who engage in intensive training, as there is no need to abstain from training on the day of blood collection.
Low sample volume:
To perform the test, only a drop of blood with a volume of 25-75 µl is sufficient, which corresponds to a blood spot on filter paper with a diameter of 8-14 mm. This is extremely important in the case of newborns, individuals requiring constant laboratory monitoring or patients in severe condition.
Possibility of sample collection at home and by non-medical personnel:
The ability to self-collect at home may be important for immunocompromised patients for whom a visit to a collection centre may present additional risks.
DBS collection is a good solution for individuals with limited mobility.
It facilitates conducting screening tests on large populations in conditions where access to specialized medical facilities is limited.
High stability of analytes:
Drying blood on filter paper inhibits or even stops the rate of metabolic processes, allowing for longer stability of the tested compounds.
Low infectivity in transport and handling:
Drying the material inactivates HIV and prevents transmission of HBV - only suspension in liquid may carry a risk of potential virus transmission, but only if there would be direct transmission of infected liquid into the bloodstream of the exposed person.
Easy and undemanding transport/storage:
It is possible to transport and store a larger number of samples using the same space.
The risk of damage or contamination of DBS samples is minimal.
No special environmental conditions are required during transport and short-term storage of the samples.

Limitations in the use of dried blood spots:

Contraindications for the collecting test material in the form of DBS:

Milestones in the development of DBS-based research

The primary medical applications of dried blood spots date back to the early 20th century. In 1907, Ivar Christian Bang first mentioned the use of blood applied to a special filter paper in glucose testing. The original publication on the subject appeared in 1913. Eventually, Bang was recognised as a pioneer and founder of modern clinical microchemistry.

At the same time, in 1911, Noguchi developed a version of the Wasserman test. He investigated the presence of antibodies directed against Treponema pallidum (the bacterium that causes syphilis) in the patient’s serum, using filter paper as a carrier for the antigen.

Intensive research on the use of filter paper as a substrate for collecting samples for serological studies had already been conducted by 1939. Experiments were carried out on various types of filter paper, extraction methods, external factors, and specimen stability during transportation.

The turn of the 1950s and 1960s was significant for research based on dried blood spot. The first reports on the utilization of dried blood spot in diagnosis appeared in 1957, when it was used for the detection of Eastern equine encephalitis. In the same year, a device for cutting standardised discs was employed for the first time, and a year later, urine blotting paper was used in tests for the early detection of phenylketonuria in newborns. The years between 1961 and 1963 marked the beginning of a new era of screening research. During that time, Robert Guthrie developed and published an analytical method for the determination of phenylalanine in dried blood spot, which allowed for testing on an unprecedented scale.

The late 1990s proved to be another breakthrough in dry blood drop-based diagnostics. The idea of utilizing tandem mass spectrometry for multiparameter analysis from a single filter paper disc opened new perspectives for screening tests. It enabled the determination of a wide range of substances in single analysis, significantly reducing testing time, and due to the high stability of the analytes on the filter paper, resulting in the possibility of screening entire populations.

Newborn screening for rare inborn metabolic diseases (such as maple syrup urine disease, tyrosinaemia, citrulinaemia, organic acid disorders, fatty acid oxidation disorders) allows for early detection of disorders and enables rapid implementation of treatment, significantly reducing disability and mortality rates.

Dried blood spot applications

The recent years have resulted in intensive development of novel methods for testing using dried blood spot (DBS). These include the determination of amino acids, acylcarnitines, prostaglandins, cytokines, antibodies (such as anti-SARS-CoV-2), lipids, enzymes, hormones, tumour markers, vitamins, trace elements, drugs, and narcotics. The work is also ongoing on the use of DBS for flow cytometry analysis of leukocytes.

Other important applications of DBS include DNA/RNA molecular methods, immunological testing and nutritional assessments for children and adults. With advances in immunoassays and molecular techniques, DBS-based methods are currently used for detecting surface antigen of hepatitis B virus, antibodies against HBV core antigen and antibodies against hepatitis C virus (HCV antigen), detecting HCV RNA and 1-p24 antigen of human immunodeficiency virus (HIV) as well as anti-HIV antibodies. Fully automated platforms or sensitive qualitative nucleic acid assays are used for detection.

Dried blood spot tests also enable the detection of infectious agents. Early applications of DBS include serological tests for the diagnosis of syphilis or the detection of antibodies against measles, mumps, polio virus, pseudomumps virus, respiratory syncytial virus.

Potential applications of DBS also include toxicokinetic and pharmacokinetic studies, metabolic syndrome studies, therapeutic drug monitoring, forensic and clinical toxicology, and environmental contamination control. To date, protocols for DBS have been developed for drugs such as acetaminophen, aspirin, bosentan, caffeine, diazepam, omeprazole, procaine, valsartan, and metformin. In addition, DBS is used for detecting many metabolic intermediates, e.g., bile acids, carnitine, creatinine and homocysteine, as well as haemoglobin variants.

The possibility of using the dried blood spot technique for animal research is also important. It significantly reduces the amount of test material collected, as well as stress, pain and discomfort associated with the necessary research procedures.

However, a dried blood spot is just the beginning of a revolution in the development of alternative systems for collecting test material.

Read more about the microsampling systems available on the market.

Literature

„Ivar Christian Bang (1869-1918), founder of modern clinical microchemistry”
Clinical Chemistry, 1986, 32(1), 213–215; doi: 10.1093/clinchem/32.1.213
„Some critical considerations on the serum diagnosis of syphilis”
Experimental Biology and Medicine, 1909, 6(3), 77–81; doi: 10.3181/00379727-6-36
„Dried Blood Spots: Applications and Techniques”
pod redakcją Wenkui Li, Mike S. Lee
„Clinical chemistry and dried blood spots: increasing laboratory utilization by improved understanding of quantitative challenges”
Bioanalysis, 2014, 6(21), 2791–2794; doi: 10.4155/BIO.14.237
„Official International Association for Therapeutic Drug Monitoring and Clinical Toxicology Guideline: Development and Validation of Dried Blood Spot-Based Methods for Therapeutic Drug Monitoring”
Therapeutic Drug Monitoring, 2019, 41(4), 409-430; doi: 10.1097/FTD.0000000000000643
„Dried blood spots: Effects of less than optimal collection, shipping time, heat, and humidity”
American Journal of Human Biology, 2020, 32(5), e23390; doi: 10.1002/ajhb.23390
„A review of microsampling techniques and their social impact”
Biomedical Microdevices, 2019, 21(81); doi: 10.1007/s10544-019-0412-y
„Tutorial: Volumetric Absorptive Microsampling (VAMS)”
Analytica Chimica Acta, 2018, 1046, 32-47; doi: 10.1016/j.aca.2018.09.004
„Dried blood spots: Concepts, present status, and future perspectives in bioanalysis”
Drug Testing and Analysis, 2014, 6(5), 399-414; doi: 10.1002/dta.1646
„Cell Analysis from Dried Blood Spots: New Opportunities in Immunology, Hematology, and Infectious Diseases””
Advanced Science News, 2021, 8, 2100323; doi: 10.1002/advs.202100323
„Sensitive Detection of SARS-CoV-2–Specific Antibodies in Dried Blood Spot Samples”
Emerging Infectious Diseases, 2020, 26(12); doi: 10.3201/eid2612.203309
„Human Saliva Collection Devices for Proteomics: An Update”
International Journal of Molecular Science, 2016, 17, 846; doi: 10.3390/ijms17060846
„Guidelines for the Shipment of Dried Blood Spot Specimens”
CDC, Infant Screening, 1993, 16(1);

The above advantages were already recognized in the 1960s in the screening of newborns for inborn metabolic disorders. Since then, extensive work has been underway to use and implement DBS in various diagnostic fields - from scientific and specialized research to its use in basic laboratory testing.

Masdiag Laboratory has developed and implemented a wide range of tests based on dried blood spot.

With the aim of sales dedicated to individual customers, the Precision Diagnostics brand https://diagnostykaprecyzyjna.pl has been created, allowing tests to be purchased with "your blood collection kit" attached.

You can order
our tests online at:

diagnostykaprecyzyjna.pl

More information

We offer our business clients the option to purchase dried blood spot tests through the platform https://partnerzy.masdiag.pl.

The key information about the cooperation schemes can be found in the COOPERATION tab.

List of dried blood spot methods:

Abbreviation	Method
VITD_DBS	Quantitative determination of vitamin D metabolites in DBS by LC-MS/MS
AA_DBS	Quantitative determination of amino acid profile in DBS by LC-MS/MS technique
AC_DBS	Quantitative determination of acylcarnitine profile in DBS by the LC-MS/MS technique
HCY_DBS	Quantitative determination of homocysteine in DBS by LC-MS/MS technique
OMEGA_DBS	Quantitative determination of the fatty acid profile in DBS by GC-FID
THC_DBS	Quantitative determination of tetrahydrocannabinol (THC) in DBS by LC-MS/MS technique
PAS_DBS	Semi-quantitative determination of psychoactive substances in DBS by LC-MS/MS technique
AEQ10_DBS	Quantitative determination of vitamins A, E, and coenzyme Q10 in DBS by LC-MS/MS technique
BORRELIA_DBS	Quantitative determination of antibodies against Borrelia spirochetes in the IgM and IgG class in DBS by ELISA
TSH_DBS	Quantitative determination of thyrotropin (TSH) in DBS by CLIA technique
fT4_DBS	Quantitative determination of free thyroxine (fT4) in DBS by CLIA technique
CBD_DBS	Quantitative determination of CBD, THC, and their metabolites in DBS by LC-MS/MS technique
GSH_DBS	Quantitative determination of glutathione index in DBS by LC-MS/MS technique
3-OMD_DBS	Quantitative determination of 3-O-methyldopa in DBS by LC-MS/MS technique

Watch the video on how to collect a sample:

DBS testing for businesses and international partners — patient-centric sampling

Masdiag Laboratory offers outsourced dried blood spot (DBS) analysis for companies across Europe and beyond. DBS is a patient-centric sampling approach — the patient collects a few drops of capillary blood at home with a simple finger prick, dries the sample on filter paper, and ships it to our laboratory via standard post. No clinic visit. No cold chain. No venipuncture.

This approach is increasingly adopted by supplement companies, nutraceutical brands, health tech platforms and clinical research organisations as a scalable, convenient alternative to conventional blood testing.

✓ No cold chain required — ships as non-hazardous material from anywhere in Europe
✓ API integration with your platform or ordering system
✓ White-label result reporting in your preferred format
✓ ISO 15189 compliant | DEQAS | ERNDIM | NSQAP
✓ Partners in Germany, UK, Sweden, USA and Australia

Test material: Dried blood spot (DBS), serum, plasma | Method: LC-MS/MS | Available for: individual patients · B2B partners · international clients · clinical research

B2B & international cooperation → Order a test →

Frequently Asked Questions

DBS Basics

What is dried blood spot (DBS) testing?

Dried blood spot (DBS) testing is a microsampling technique in which a small volume of capillary blood — obtained via a simple finger prick — is applied to a filter paper card and allowed to dry. Once dry, the sample is stable at room temperature and can be sent to a laboratory for analysis. DBS is a patient-centric alternative to conventional venous blood collection, requiring no clinic visit, no trained medical personnel, and no cold chain for transport.

How do I collect a DBS sample at home?

Collection is straightforward: use the supplied lancet to prick your fingertip, apply drops of blood to the marked circles on the filter paper card, allow the card to dry horizontally for 2–3 hours at room temperature, then place it in the provided envelope and send it to our laboratory by standard post. Detailed instructions are included in every collection kit.

Is DBS as accurate as a standard blood test?

For the analytes we measure, DBS provides results that are clinically comparable to those obtained from venous blood. Our methods are validated against conventional serum and plasma samples, and our laboratory participates in multiple international external quality assessment programmes — including DEQAS for vitamin D and ERNDIM for metabolic markers — which independently verify our analytical accuracy.

Are DBS results comparable to results from conventionally collected blood samples?

Yes, for the biomarkers in our portfolio. DBS contains whole blood, which differs slightly in composition from serum or plasma. For each analyte we offer, we have validated the correlation between DBS and conventional sample types. In some cases — such as vitamin D metabolite profiling — we have published this validation data in peer-reviewed scientific journals. Where clinically relevant reference intervals differ between sample types, we provide DBS-specific reference ranges.

Is DBS testing recognised and accepted by the medical community?

Yes. DBS has been used in clinical diagnostics for over 60 years, originally for newborn screening programmes which remain the gold standard application of the technique worldwide. In recent years, DBS has gained broad acceptance in therapeutic drug monitoring, nutritional assessment, endocrinology and metabolomics. Regulatory bodies including the EMA and FDA have issued guidance documents on the use of DBS in pharmacokinetic studies. Our methods are developed in line with international scientific guidelines and validated according to recognised standards.

How stable are DBS samples during transport?

DBS samples are remarkably stable. Drying blood on filter paper inhibits enzymatic and metabolic processes, significantly extending the stability of most analytes compared to liquid samples. Determining the stability of each biomarker in DBS is an integral part of our method development process — we include only tests in our routine portfolio for which stability has been confirmed for a minimum of 4 weeks at room temperature. Stability data for specific analytes is available on request.

Do DBS samples require refrigeration or a cold chain?

No. This is one of the key advantages of DBS over conventional blood samples. DBS cards can be transported and stored at room temperature using standard postal services without any special cooling requirements. We always recommend placing the dried card in a resealable bag with a desiccant sachet before shipping — this protects the sample from moisture during transit. No dry ice, no refrigerated courier, no special handling — which makes DBS particularly well suited for international shipping and large-scale programmes.

Logistics & International Shipping

Can DBS samples be shipped internationally?

Yes, in most countries. We regularly receive DBS samples from international partners and clients in Germany, the United Kingdom, Sweden, the United States, Australia and other countries. DBS cards ship easily via standard international courier or postal services — no special permits or cold chain infrastructure are required. Please note that some countries impose restrictions on the import or export of biological material even in dried form — China and Mongolia are examples where such restrictions currently apply. We recommend verifying local regulations before establishing an international shipping workflow, and our team can advise based on our experience with existing international partnerships.

Are DBS samples considered infectious material for shipping purposes?

No. Dried blood spot samples are classified as non-infectious material for transport purposes. Drying the blood inactivates most pathogens — including HIV and hepatitis B virus — significantly reducing the biohazard risk compared to liquid blood samples. This means DBS cards can be shipped as standard, non-hazardous mail, without the regulatory requirements, special packaging or documentation associated with Category B biological substances. This classification applies under standard international postal and courier regulations.

What are the shipping requirements for DBS samples?

DBS samples should be fully dry before packaging (minimum 2–3 hours drying time). Place the dried card in a resealable bag with a desiccant sachet, then into a standard envelope or padded mailer. No refrigeration, dry ice or special courier service is required. We provide detailed shipping instructions with every collection kit, and our team is available to advise international partners on optimal packaging for their specific programme.

How long does it take to get results after shipping a DBS sample?

Turnaround time depends on the specific test. Results are typically available within 3 to 14 working days from the date the sample is received and accepted by our laboratory. More complex analyses or custom method panels may take longer. Exact turnaround times for each test are available on our methods page, and international B2B partners can agree specific turnaround commitments as part of their cooperation terms.

What happens if my DBS sample is rejected due to poor quality?

Every sample that arrives at our laboratory undergoes a quality assessment as the first step in processing. We evaluate criteria including spot diameter, blood saturation, uniformity and potential contamination. If a sample does not meet our acceptance criteria, the client is notified promptly and a repeat collection is requested at no additional charge for the analysis. To help reduce rejection rates before samples are even shipped, we offer a proprietary mobile application that allows patients or collection staff to photograph the DBS card and receive immediate quality feedback — enabling re-collection on the spot if needed.

B2B Cooperation & Technical Integration

Can Masdiag integrate with our platform via API?

Yes. Masdiag operates its own in-house IT department, which enables us to offer direct API integration between your ordering system, platform or application and our laboratory information system. We support automated order submission, sample tracking and result delivery in formats adapted to your technical requirements — including JSON, CSV or custom data structures. Integration is set up as part of the onboarding process for new B2B partners.

Do you offer white-label result reporting?

Yes. Results can be delivered under your brand, formatted to your specification. This is particularly relevant for companies offering home testing kits or health monitoring services where the end customer interacts with your platform rather than directly with our laboratory. We discuss reporting format, branding and delivery method during the initial partnership setup.

Can you supply DBS collection kits for our customers?

Yes. In addition to laboratory analysis, we can supply DBS collection kits tailored to your testing programme. Kits can be configured for self-collection by patients at home or for collection in a clinical setting. We advise on the appropriate components — filter paper, lancet type, desiccant, packaging and printed instructions — and can ship kits directly to your customers or to your fulfilment operation. If needed, kits can be supplied as white-label, branded with your company name and design.

Which filter papers and volumetric devices do you support?

Our standard collection material is the TFN filter paper card, which is used across our routine portfolio. We also have validated experience with a range of alternative materials including 903 filter paper, HemaSep, Capitainer and Mitra microsampling devices, among others. If you are working with a specific collection material or evaluating new options, we are happy to discuss compatibility and conduct comparative validation studies as part of the partnership setup.

What guidelines does Masdiag follow when developing DBS analytical methods?

Our methods are developed and validated in accordance with international quality standards, including ISO 15189, CLSI guidelines and FDA requirements. All methods also comply with the IVDR (In Vitro Diagnostic Regulation) as it applies to laboratory-developed tests (LDTs). Determining analyte stability in DBS is a mandatory part of every method development process — we include only tests in our routine portfolio for which stability has been confirmed for a minimum of 4 weeks at room temperature.

What certifications does Masdiag hold for DBS testing?

Masdiag Laboratory operates under the ISO 15189 quality management standard for medical laboratories. We participate in five international external quality assessment programmes: DEQAS (vitamin D), ERNDIM (metabolic disorders and IEM), NSQAP (newborn screening), QUARTZ (forensic toxicology) and RCPAQAP (Royal College of Pathologists of Australasia). These programmes provide continuous, independent verification of our analytical performance across all key test areas.