The level of bilirubin reflects the degree of damage to the liver cells. High total bilirubin means that the patient may be suffering from biliary tract and liver diseases. 1. Biliary tract diseases: When there is a disease in the biliary tract, which obstructs the bile duct, direct bilirubin enters the intestines from the biliary tract, and flows backward into the bloodstream, the symptom of elevated total bilirubin will appear. 2. Liver disease: the liver is the place where direct bilirubin and indirect bilirubin are converted. When liver disease occurs, the ability of bilirubin conversion decreases, which increases the bilirubin in the blood and leads to the elevation of total bilirubin. The external manifestations of the patient are yellowing of the skin, yellowing of the eyes, yellowing of the urine and other symptoms. Patients with high total bilirubin should also consider factors such as leukemia, severe anemia, and hemolytic anemia. Bilirubin increases when the red blood cells in the body are destroyed in large quantities, thus the liver is unable to convert all of the bilirubin, resulting in higher bilirubin in the blood. Patients with high total bilirubin should go to the hospital in time to find out the cause and get treatment.