The three bilirubins are conjugated bilirubin, unconjugated bilirubin, and total bilirubin. Carriers of thalassemia may have elevated triple bilirubin in the presence of severe hepatic impairment complicated by hemolysis. Thalassemia, or disorders of beaded protein production, are hemolytic disorders caused by genetic defects. Common symptoms include intrauterine fetal death and miscarriage. After birth, patients may develop anemia ranging from mild to moderate to severe, with jaundice, hepatosplenomegaly, and skeletal changes. In severe cases, cardiopulmonary complications such as heart failure, pericarditis, arrhythmias and pulmonary hypertension may occur, and some children may have significant liver impairment. Before thalassemia develops hepatic impairment, hemolytic anemia itself will only lead to a rise in total bilirubin and unconjugated bilirubin, but not in conjugated bilirubin. However, as the disease progresses and liver function is impaired, or even cirrhosis occurs, the combined bilirubin, unconjugated bilirubin, and total bilirubin will all rise. It is recommended that once thalassemia is detected, one should consult a doctor in a timely manner for scientific treatment and follow-up under the doctor’s guidance.