Urine is the principal mode for excretion of absorbed bismuth. This element is considered to be only slightly toxic with ingestion of gram quantities necessary before signs of toxicity occur. Only between 5 and 10% of orally ingested, soluble bismuth salts are absorbed into the blood.

Bismuth is a byproduct of lead and copper ore refining. Bismuth has therapeutic uses with antimicrobial, anti-secretory and anti- inflammatory actions. Bismuth subsalicylate ("Pepto-Bismol") hydrolyzes in the stomach to salicylic acid and insoluble bismuth; it can be effective in halting traveler's diarrhea. Historically, bismuth was used to treat syphilis. Bismuth is used commercially in low-melting- point alloys and solders and is commonly in "automatic" sprinkler heads for in-building fire protection. Bismuth often is a component of: pigments, paints, glazes for ceramics,glass, and some semiconductor materials. Some cosmetics including lipstick may contain bismuth oxides as a pigment (pearlescent white). Dry cell battery electrodes (cathode) may contain bismuth.

At sub-gram quantities, no toxic effects are documented for bismuth. Also, the existence of health problems due to environmental pollution by bismuth is not documented (Tsalev p. 101, 1983). Early physiological signs of bismuth excess may include: constipation or bowel irregularity, foul breath, skin pigmentation changes, and gum pigmentation (blue-black) with stomatitis.

Laboratory tests that help to assess bismuth status are whole blood and hair element analyses. Some increase in urine bismuth may follow administration of dithiol chelators (DMPS,DMSA). Bismuth has a very high affinity for sulfhydryl groups.