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Background: The therapeutic and safety claims made for bhasmas rest on assumptions about how much of the metal is absorbed, where it goes and how it is eliminated. These assumptions are rarely tested. Objective: To map the available evidence on the absorption, distribution, metabolism and excretion of metal and mineral bhasmas and related herbo-mineral formulations, and to identify the main evidence gaps. Methods: A structured narrative review following scoping principles. Studies reporting dissolution or bioaccessibility in simulated gastrointestinal fluids, cellular uptake, animal blood or tissue metal levels, or human pharmacokinetic data were identified through bibliographic databases and reference lists and charted by study type and metal. Results: The evidence base is small and dominated by in vitro and animal studies. For gold, rat studies show measurable absorption with large differences between commercial products (peak blood gold 4.66–8.55 µg/L after 0.8 mg/kg), and cell studies show that intact aggregates and fine fractions enter cells by different routes. For iron and zinc bhasmas, simulated digestion and Caco-2 models show pH-dependent dissolution and uptake that can be raised by size reduction and ascorbic acid (about threefold for a modified Mandura bhasma). For mercurials, mercuric sulphide shows low solubility and absorption relative to other mercury compounds. Human pharmacokinetic data are almost absent. Conclusion: Bhasmas are absorbed, but the extent depends on composition, surface area and dissolution rather than on the classical label. Standardised dissolution testing and small human pharmacokinetic studies are the priorities.