Published on July 12, 2019

Did you know that your blood spot sample could be denied for testing if not done properly? It is especially important to provide a quality sample with multiple tests being performed from each blood spot sample.

We originally reviewed this topic back in March, and have decided to touch on it again due to the importance of providing a proper sample, especially with the new Elements Panel.

What Does a Proper Blood Spot Look Like?

An acceptable blood spot should:

  • Be at least 1/4 inches in diameter, the same size as a regular pencil eraser on the front of the filter paper (this is the size of the smaller circles on our 2 and 4 spot blood spot cards)
  • Soak completely through to the back of the filter paper, so that the sample is at least 1/4 inches in diameter on both the front and the back
    • ***PLEASE VERIFY before you seal your sample in your return envelope! If the first try does not look acceptable, use the extra lancet to try again.
  • Not overlap with any other blood spots on the filter paper

Each test needs a minimum number of good spots in case a rerun is deemed necessary by the lab.

  • For a vitamin D test, a minimum of 2 good spots are necessary
  • For a magnesium or Elements panel, a minimum of 4 good spots are necessary
  • For an HbA1c or hsCRP, a minimum of 2 good spots are necessary
  • For a TSH test, a minimum of 2 good spots are necessary
  • For an Omega-3 Index, with or without the additional ratios, a minimum of 2 good spots are necessary

When in question, you can always take a picture of your blood spots and email the picture to [email protected] for feedback/advice on how to proceed.

Because of the importance of getting enough quality blood spots for the Elements Panel, participants receive a larger blood spot card in their test kit, which includes 12 large circles. A single drop of blood should be placed in the center of each circle. Allowing the blood to well up on the finger before applying will help ensure a large enough spot. Try to fill the circle completely, but if it’s at least 1/4″ on both sides of the paper, it is adequate. The good news about using these new cards is that both the vitamin D test and the Elements Panel test can be run from this same card!

Watch this video on how to complete your home blood spot test.

What does an Unacceptable Blood Spot Look Like?

Some examples of blood spot samples that would be rejected are shown below.


Spots are too small
(smaller than 1/4 inch in diameter; do not completely fill the circle on the 2 or 4 spot cards)


The blood spots did not completely penetrate filter paper- spots are large on the front, but do not soak through to the back


Spots are re-spotted on the same location (multiple blood spots stacked on top of each other) showing different drying rings and improper absorption


Spots soak through the back but are “marbled” in appearance because of repeated applications

A blood sample can also be rejected if the participant shut the card too soon and blood was leached from the filter paper to the card’s protective cover, leaving a diluted blood spot.

For Omega blood spot samples, there are two additional requirements.

  • They must be processed within 28 days of the date the sample was collected (it is very important to send them in immediately after doing the test).
  • The samples must be placed on the treated filter card provided for the Omega testing.

These cards may also have a slightly pinkish tinge on the filter paper (this stain is normal!), and may say “OMEGA” on the back of the card.

Tips to Get a Better Blood Spot Sample

Before collection, it may help to:

  • Drink a large glass of water.
  • Warm hands by running them under hot water, using a heating pad, or taking a shower.
  • Raise your heart rate by going up a flight of stairs or doing jumping jacks. If you have limited mobility, try pumping your opposite arm up and down (like a bird) during collection.

At the time of collection, it may help to:

  • Place the collection card below waist level. If you are able, collect standing up and place the collection card on a low table.
  • Wipe the puncture point with gauze between samples to help prevent the wound from closing.
  • Don’t squeeze too close to the puncture site, but right below, just above the knuckle. You can also massage your entire forearm, starting from your elbow.
  • Allow the blood to well up on your finger tip, so that you have a single large drop, before touching it to the card.
  • When in doubt, an extra blood spot can be applied to the filter paper outside of the circles provided, as long as the samples do not overlap.

What Happens if a Blood Spot Sample is Rejected?

If a participant sends in a blood spot sample that is determined to be insufficient, the participant will be sent an email notice based on the reason for rejection. A replacement blood spot test kit will be sent free of charge to the participant. As long as the new blood spot sample is collected within two months of the questionnaire answers, no other action is needed from the participant.

Good luck and happy bleeding!

How can I track my vitamin D intake and levels?

To help you track your supplement use and nutrient levels, GrassrootsHealth has created an online tracking system called myData-myAnswers. For each specific supplement, you can track what days you take it, how much, and many other details. This will help you know your true supplemental intake and what patterns of use work for you to reach and maintain optimum nutrient levels. Check it out today!

Click Here

How Can You Use this Information for YOUR Health?

Having and maintaining healthy vitamin D and other nutrient levels can help improve your health now and for your future. Measuring is the only way to make sure you are getting enough!

STEP 1 Order your at-home blood spot test kit to measure vitamin D and other nutrients of concern to you, such as omega-3s, magnesium, essential and toxic elements (zinc, copper, selenium, lead, cadmium, mercury); include hsCRP as a marker of inflammation or HbA1c for blood sugar health

STEP 2 Answer the online questionnaire as part of the GrassrootsHealth study

STEP 3 Using our educational materials and tools (such as our dose calculators), assess your results to determine if you are in your desired target range or if actions should be taken to get there

STEP 4 After 3-6 months of implementing your changes, re-test to see if you have achieved your target level(s)

Enroll in D*action and Build Your Custom Test Kit!