A total bilirubin of 27.5 μmol/l is considered high and is usually abnormal. Total bilirubin is the sum of direct bilirubin and indirect bilirubin, with a normal value of 1.71-17.1 μmol/L. Elevated total bilirubin may be due to physiological factors such as staying up all night, or pathologic factors such as damage to the hepatocytes or bile duct obstruction. 1. Physiological factors: Bad habits such as staying up late, drinking heavily and overworking may cause transient damage to liver cells, leading to elevated total bilirubin. When strenuous exercise, the body’s red blood cell renewal speed will be accelerated, may also lead to total bilirubin increased. 2. Pathological factors: viral hepatitis, fatty liver, cirrhosis, liver cancer and other liver diseases, there will be a certain degree of liver cell damage, resulting in increased total bilirubin; gallbladder stones, bile duct stones and other biliary tract obstruction diseases, which will affect the excretion of bilirubin, can lead to increased total bilirubin. In addition, hemolytic diseases, such as hemolytic anemia, can increase the destruction of red blood cells and increase the number of sources, which can also elevate total bilirubin. If a patient’s examination reveals a total bilirubin of 27.5 μmol/l, it is advisable to seek prompt medical attention to identify the cause and target treatment.