Bismuth is found in some gastrointestinal medications, cosmetics, and industrial materials. It has limited absorption from the gut and is generally considered less toxic than other heavy metals.
Once absorbed, bismuth is cleared through the kidneys. Elevated urine levels usually reflect recent medication use rather than toxicity. At very high levels, bismuth can cause kidney stress and neurologic symptoms.
Low levels are expected in individuals without recent exposure. Urine testing helps distinguish benign medication related exposure from excessive intake.