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Vitamin D testing accuracies, including dried blood spot – Jan 2020

Vitamin D testing: advantages and limits of the current assays

European Journal of Clinical Nutrition (2020)
Barbara Altieri, Etienne Cavalier, Harjit Pal Bhattoa, Faustino R. Pérez-López, María T. López-Baena, Gonzalo R. Pérez-Roncero, Peter Chedraui, Cedric Annweiler, Silvia Della Casa, Sieglinde Zelzer, Markus Herrmann, Antongiulio Faggiano, Annamaria Colao & Michael F Holick

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Vitamin D blood test misses a lot  

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  • Vitamin D Measurement, the Debates Continue, New Analytes Have Emerged, Developments Have Variable Outcomes - Nov 2019, Free PDF DOI: 10.1007/s00223-019-00620-2

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Vitamin D deficiency and insufficiency has become a pandemic health problem with a consequent increase of requests for determining circulating levels of 25-hydroxyvitamin D [25(OH)D]. However, the analytical performance of these immunoassays, including radioimmunoassay and ELISA, is highly variable, and even mass spectrometric methods, which nowadays serves as the gold standard for the quantitatively determination of 25(OH)D, do not necessarily produce comparable results, creating limitations for the definition of normal vitamin D status ranges. To solve this problem, great efforts have been made to promote standardization of laboratory assays, which is important to achieve comparable results across different methods and manufacturers. In this review, we performed a systematic analysis evaluating critically the advantages and limits of the current assays available for the measure of vitamin D status, i.e., circulating 25(OH)D and its metabolites, making suggestions that could be used in the clinical practice. Moreover, we also suggest the use of alternatives to blood test, including standardized surveys that may be of value in alerting health-care professionals about the vitamin D status of their patients.

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Dried blood spots (DBSs)
Although serum and plasma are standard for measuring the circulating 25(OH)D concentration, DBSs are increasingly exploited in large-scale epidemiological studies [97, 98]. There is good agreement between measurements of 25(OH) D from DBS and plasma, which makes DBS an accurate and robust method that can be used to screen 25(OH)D concentrations [99-102]. Also, the use of DBS for measuring 25(OH)D offers several advantages over serum or plasma. Collection of blood spots is minimally invasive.
Only a small volume is required for the extraction and quantification of 25(OH)D [103]. In addition, DBSs require no refrigeration and are stable in the dark at room temperature, are suitable for long-term storage, and can be easily transported. This creates many opportunities in medical research; for example, DBS routinely collected on Guthrie cards at birth can be used to determine how neonatal vitamin D status affects health outcomes later in life


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