The normal value of total bilirubin is about 3.4 to 17.1 umol/L, and 45.7 umol/L is considered high. High total bilirubin can be categorized into elevated indirect bilirubin, elevated direct bilirubin and both. 1. Indirect bilirubin is predominantly high: it can be seen in hemolytic jaundice caused by hemolytic anemia and other hemolytic jaundice. A large number of red blood cells are destroyed, and a large amount of unconjugated bilirubin is produced, which exceeds the ability of liver cells to take up and conjugate bilirubin, resulting in jaundice and elevated bilirubin. 2. High direct bilirubin is the main cause of jaundice: it can be seen in obstructive jaundice caused by pancreatic head cancer, cholangiocarcinoma, gallstones and so on. Bile duct obstruction causes bilirubin in bile to flow backward into blood, leading to jaundice and elevated bilirubin. 3. Both direct and indirect bilirubin are elevated: it can be seen in viral hepatitis, fatty liver, cirrhosis, primary sclerosing cholangitis and so on. These diseases lead to liver cell damage, causing bilirubin metabolism disorder, resulting in jaundice and elevated bilirubin. Elevated total bilirubin should go to the hospital, further improve the examination, clarify the cause, according to the cause of treatment.