Optimal Result: 0 - 2.28 ug/g creat.

Used in alloys, electronics, batteries, crystal ware, cosmetics, flame retardants,and in antimicrobial therapy (H. pylori), antiseptic dressings, paraffin paste. Bismuth medical therapies exhibit high therapeutic effects and little side effects, though over-dosage can cause toxicity.

Very limited absorption in the GI tract. When absorbed, it binds mainly to transferrin and lactoferrin, interacts with enzymes due to a high affinity to cysteine residues, blocking the active site. Can accumulate in the kidney, lung, spleen, liver, brain, and muscles, while being eliminated in urine and feces via bile and intestinal secretions.


Liu Y, Shen C, Zhang X, et al. Exposure and nephrotoxicity concern of bismuth with the occurrence of autophagy. Toxicol Ind Health. 2018;34(3):188-199.

Atwal A, Cousin GC. Bismuth toxicity in patients treated with bismuth iodoform paraffin packs. Br J Oral Maxillofac Surg. 2016;54(1):111-112.

Wang R, Li H, Sun H. Bismuth: Environmental Pollution and Health Effects. Encyclopedia of Environmental Health. 2019:415- 423.

Liu X, Xiao M, Xu L, Miao Y, Ouyang R. Characteristics, applications and determination of bismuth. Journal of Nanoscience and nanotechnology. 2016;16(7):6679-6689.

Slikkerveer A, de Wolff FA. Pharmacokinetics and toxicity of bismuth compounds. Med Toxicol Adverse Drug Exp. 1989;4(5):303-323.

Goyer RA, Clarkson TW. Toxic effects of metals. Casarett and Doull’s toxicology: the basic science of poisons. 1996;5:696-698.

What does it mean if your Bismuth result is too high?

Nephropathy (= deterioration of kidney function), GI complaints, encephalopathy (= disease of the brain that alters brain function or structure), difficulty walking/standing, memory deterioration, behavioral change, insomnia, muscle cramping. Decreased appetite, weakness, gingivitis (= a common and mild form of gum disease), dermatitis (= common skin irritation), and diarrhea have also been seen clinically with chronic bismuth toxicity.

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