Bismuth (Bi) is a chemical element with the atomic number 83. Supplements containing bismuth usually contain bismuth as a salt.
Bismuth salts are most commonly used for travelers' diarrhea, a digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori), and stomach ulcers. It is also used for many other conditions, but there is no good scientific evidence to support these other uses.
In manufacturing, bismuth salts are also added to cosmetics, batteries, paints, and pigment plastics.
Bismuth supplements often contain bismuth as bismuth subsalicylate, bismuth subcitrate, bismuth subgallate, and other salt forms. See separate listing for bismuth nitrate.
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Bismuth salts seem to help eliminate bacteria that cause stomach problems such as diarrhea and stomach ulcers. Bismuth salts also work like an antacid to treat problems such as indigestion. Bismuth also might speed up blood clotting.
When taken by mouth: Taking a certain bismuth salt called bismuth subgallate by mouth, short-term and as directed, is LIKELY SAFE for most people. Also, another bismuth salt called bismuth subsalicylate is LIKELY SAFE when taken by mouth short-term and as directed. Other forms of bismuth salts are POSSIBLY SAFE when taken by mouth, short-term. Bismuth salts, including ranitidine bismuth citrate, colloidal bismuth subcitrate, and bismuth subnitrate appear to be safe when taken in doses of 400-2100 mg daily for up to 56 days.
Bismuth is POSSIBLY UNSAFE when taken by mouth in large amounts due to the risk for kidney failure, and when taken over the long-term due to the risk of nerve damage.
When applied to the skin: There isn't enough reliable information to know if bismuth is safe or what the side effects might be.
When given as an enema (rectally): There isn't enough reliable information to know if bismuth is safe or what the side effects might be.
Special Precautions & Warnings:Pregnancy and breast-feeding: There isn't enough reliable information to know if bismuth is safe to use when pregnant or breast-feeding. Stay on the safe side and avoid use.
Children: Bismuth subgallate and bismuth subsalicylate are LIKELY SAFE when taken by mouth short-term and as directed. Taking 200-400 mg of bismuth subgallate by mouth up to four times daily is approved by the US FDA as a deodorant drug for children at least 12 years-old. Taking 1.05 grams of bismuth subsalicylate by mouth hourly as needed (no more than 4.2 grams daily) for up to 2 days is approved by the US FDA for diarrhea in children at least 12 years-old. There is not enough reliable information about the safety of taking other bismuth salts by mouth in children. Bismuth is POSSIBLY UNSAFE when taken by mouth in large amounts or over a prolonged time period.
Allergy to salicylate: Many bismuth supplements contain the bismuth salt called bismuth subsalicylate. When taken by mouth, bismuth subsalicylate breaks down in the stomach to form bismuth and salicylate. In theory, people who are sensitive to salicylate might have a serious side effect to these supplements.
Gut problems: Normally, almost no bismuth is absorbed by the gut. But having problems in the gut might increase how much bismuth is absorbed. This might increase side effects of bismuth.
There are no known interactions with medications. Before taking this product, talk with your health professional if you take any medications.
Herbs that contain chemicals similar to aspirin (salicylates): Many dietary supplements contain bismuth in the form of bismuth subsalicylate. When taken by mouth, bismuth subsalicylate is broken down to form bismuth and salicylate. In theory, taking other herbs that also contain salicylate with bismuth subsalicylate might increase both effects and side effects. Other herbs that contain salicylate include black haw, poplar, meadowsweet, and willow bark.
There are no known interactions with foods.
The following doses have been studied in scientific research:
- For a digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori): As a triple therapy, 120 mg bismuth subcitrate, 500 mg amoxicillin, and 250 mg metronidazole four times daily for 14 days have been used. As a bismuth quadruple therapy (BQT), 240-1680 mg of bismuth salts daily, 400-1500 mg of metronidazole daily, 1500-2000 mg of tetracycline daily, and a medication that decreases stomach acid (proton pump inhibitor) for a total of 7 to 14 days have been used. Also as BQT, 480-600 mg of bismuth salts daily, 2000 mg of amoxicillin daily, a proton pump inhibitor, and 100 mg clarithromycin or 1500 mg metronidazole each day for 10-14 days has been used.
- For stomach ulcers: 700 mg of bismuth subnitrate three times daily for 4 weeks has been used. Also, 300 mg of bismuth subnitrate four times daily, 20 mg of omeprazole twice daily, and 500 mg of amoxicillin four times daily for 2 weeks have been used.
- For travelers' diarrhea: For prevention, 1.05-2.1 grams of bismuth subsalicylate in two divided doses daily beginning the day before traveling and continuing until 2 days after returning home has been used. As treatment, 525 milligrams of bismuth subsalicylate every 30-60 minutes for a maximum of 8 doses per 24 hours has been used.
Atomic number 83, Basic Bismuth Carbonate, Basic Bismuth Gallate (BSG), Basic Bismuth Nitrate (BSN), Bi, Bismuth, Bismuth Aluminate, Bismuth Biskalcitrate, Bismuth Carbomer, Bismuth Citrate, Bismuth Gallate, Bismuth Oxynitrate, Bismuth Phosphate, Bismuth Salts, Bismuth Sodium Triglycollamate, Bismuth Subcarbonate, Bismuth Subcitrate, Bismuth Subgallate, Bismuth Subnitrate, Bismuth Subsalicylate, Bismuth-Peptide Complex (BPC, bicitropeptide), Colloidal Bismuth Subcitrate, Ranitidine Bismuth Citrate, Tripotassium Dicitrato Bismuthate.
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