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Bismuth Subgallate Toxicity in the Age of Online Supplement Use

Bismuth Subgallate Toxicity in the Age of Online Supplement Use

Paul Sampognaro, Kathy T Vo, Megan Richie, Paul D Blanc, Kevin Keenan

Neurologist. 2017 Nov;22(6):237-240.

PMID: 29095326

Abstract:

Introduction:
Bismuth salts have been used to treat gastroenterological disorders and are readily available over-the-counter and via the internet. Even though generally considered safe, bismuth compounds can cause a syndrome of subacute, progressive encephalopathy when taken in large quantities.
Case report:
We present the case of woman who developed progressive encephalopathy, aphasia, myoclonus, and gait instability after chronically ingesting large amounts of bismuth subgallate purchased from a major online marketing website to control symptoms of irritable bowel syndrome. After extensive neurological work-up, elevated bismuth levels in her blood, urine, and cerebrospinal fluid confirmed the diagnosis of bismuth-related neurotoxicity. She improved slowly following cessation of exposure.
Conclusion:
This case highlights bismuth subgallate as a neurotoxic bismuth formulation and reminds providers of the potential for safety misconceptions of positively reviewed online supplements.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP99263	Bismuth subgallate		99-26-3	Price

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