Bismuth is a naturally occurring metal used to manufacture solder, fishing anchors, shotgun pellets, and more. Many cosmetics and pharmaceuticals also contain bismuth in various forms. Bismuth subsalicylate is an active ingredient in many popular, over-the-counter upset stomach remedies. Bismuth oxychloride is used in cosmetics. Bismuth subgallate is an active ingredient in products used to address flatulence odor. Although bismuth exposure is common, that does not mean it’s completely harmless.
Bismuth can be inhaled, ingested, or absorbed through the skin. The most common exposure to bismuth happens by way of working in close proximity to the element. For instance, a plumber may be exposed by breathing in soldering fumes (not good). Consuming medications that contain bismuth, or using cosmetic products that contain bismuth will also put you at risk of exposure.
Some people who hunt wild game do so to feed on a free-range animal. That can be a good intent, however, using lead shot can potentially lead to lead contamination in the meat. Bismuth has been promoted as a more-safe substitute to toxic lead in ammunition. But, a bioavailability study of bismuth shows that, like lead, bismuth can be measured in the urine and blood of animals. 
Symptoms of Bismuth Exposure
While many people will tell you that bismuth is non-toxic in small amounts, sufficient exposure can produce nausea, headache, diarrhea, and pain. According to the Department of Physiology at the University of Tübingen in Germany, anemia is another potential negative side effect of exposure to bismuth and caution is advised when taking any medication containing bismuth.  Additionally, certain metals are known to reduce sperm metabolism and contribute to infertility in men. Bismuth has been suspected to be one of those metals. 
The increasing use of nanoparticles is prompting many discussions about their safety. The absolutely tiny size of nanoparticles has presented new concerns about how easily they're absorbed and how toxic that can be to our health. The NanoScience Technology Center at the University of Central Florida warns that bismuth nanoparticles are more toxic than other bismuth compounds. 
It’s also important to note that children overcoming the chicken pox should avoid stomach remedies that contain bismuth subsalicylate as it may cause Reye's syndrome.
Avoiding Exposure to Bismuth
Avoid over the counter medicines that contain bismuth. It's usually possible to elicit the same benefit without the negative side effects by using natural alternatives instead. Additionally, if you’re in a profession that puts you at risk for bismuth exposure, take inventory and consider a change. Most environments that expose you to one toxic metal will expose you to several, it could be that bismuth is actually the least of your concerns. Drink clean water, detoxify your living spaces, and regularly cleanse your body.
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- Braun M, Föller M, Gulbins E, Lang F. Eryptosis triggered by bismuth. Biometals. 2009 Jun;22(3):453-60. doi: 10.1007/s10534-008-9180-5. Epub 2008 Dec 2.
- Ghaffari MA, Motlagh B. In vitro effect of lead, silver, tin, mercury, indium and bismuth on human sperm creatine kinase activity: a presumable mechanism for men infertility. Iran Biomed J. 2011;15(1-2):38-43.
- Luo Y, Wang C, Qiao Y, Hossain M, Ma L, Su M. In vitro cytotoxicity of surface modified bismuth nanoparticles. J Mater Sci Mater Med. 2012 Oct;23(10):2563-73. doi: 10.1007/s10856-012-4716-1. Epub 2012 Jul 17.
†Results may vary. Information and statements made are for education purposes and are not intended to replace the advice of your doctor. If you have a severe medical condition or health concern, see your physician.