Low direct bilirubin to total bilirubin ratio refers to the low percentage of direct bilirubin in total bilirubin. It may be due to zinc deficiency, iron-deficiency anemia, hemolytic jaundice, abnormal liver function, and so on. 1. When there is a severe deficiency of zinc in the body, it will lead to a low bilirubin condition in oneself. 2. Low bilirubin due to iron deficiency anemia is caused by the lack of iron in the body. When the body lacks iron, it will lead to low synthesis of its own hemoglobin, which will lead to low direct bilirubin. 3. If the patient has hemolytic jaundice or hepatocellular jaundice, it will lead to bilirubin abnormality, thus leading to low direct bilirubin. 4. Impaired liver function leads to a decrease in the ability of liver cells to synthesize glycogen as well as proteins, and thus the bilirubin that is processed in the liver is retained in the blood, leading to low direct bilirubin. If you find that the direct bilirubin to total bile ratio is low, you need to go to the hospital in time to get a clear diagnosis and treatment plan, and use medication under the guidance of the doctor, avoid self-medication.