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Insulin-like growth factor-I (IGF-I) is sensitive to nutritional stress and is reduced in soldiers during stressful field training. Methods have recently been developed to measure IGF-I from filter paper blood spots. Filter paper has advantages over traditional blood sampling in that neither blood separation equipment nor refrigeration is necessary after sample collection. This study determined whether filter paper blood spots collected in a field environment could measure IGF-I and subsequent changes during military operational stress. Thirty-four Marines participating in an 8-day military field exercise characterized by near-continuous physical work (total daily energy expenditure 17-25 MJ/day) and underfeeding (dietary intake 7.0 MJ/day) had blood samples taken on day 0, day 4, and day 8. IGF-I was measured by filter paper blood spot assays from fingertip blood samples and by conventional methods using serum. Correlation and measurement agreement were assessed. Blood spot (Day 0 152 +/- 6 ng mL(-1)Day 4 111 +/- 6 ng mL(-1)Day 8 74 +/- 4 ng mL(-1)) and serum IGF-I (Day 0 412 +/- 10 ng mL(-1)Day 4 258 +/- 14 ng mL(-1)Day 8 203 +/- 13 ng mL(-1)) concentrations declined (p0.05) progressively over the 8-day exercise. Overall, the two methods significantly (p0.05) correlated (r = 0.92); however, the blood spot values were on average 61% lower than serum, but could be used to predict serum values ( +/- 10%). IGF-I is a biomarker of metabolic status. The filter paper blood spot method for IGF-I detected reductions accompanying nutritional stress and may be of potential value for characterizing the IGF-I response when conventional blood sampling methods are not feasible.