What Is Bismuth?

USGS says bismuth is used in pharmaceuticals, including bismuth subsalicylate, the active ingredient in over-the-counter stomach remedies, and other compounds used to treat burns, intestinal disorders and stomach ulcers. It says bismuth is used as a nontoxic replacement for lead in brass, free-machining aluminum alloys and steels, and solders, and that compounds such as bismuth nitrate, bismuth oxychloride and bismuth vanadate are used to make ceramic glazes, crystalware, high-performance pigments and pearlescent pigments.

An over-the-counter bismuth subsalicylate label on DailyMed carries an allergy alert that the product contains salicylates, and says not to take it if you are allergic to salicylates, including aspirin, or are taking other salicylate products, and not to use it if you have bloody or black stool or an ulcer or bleeding problem.

Too much bismuth can affect the brain. A 2019 case report in BMC Neurology describes a patient who made a full recovery within weeks after supportive treatment and stopping bismuth, and concludes that although rare, bismuth encephalopathy should be considered in patients presenting with subacute encephalopathy and myoclonus. A 2026 case report in Cureus says stopping bismuth subsalicylate and supportive care resulted in gradual clinical improvement, with serum bismuth levels returning to normal and gradual neurological recovery over several months.