<s>[INST] My son has been feeling I ll the past week. He is tired, dizzy and feels nauseas. He just had a blood test which has indicated high levels if t bil in his liver . He is 12 years old and the level was 24. Could this be causing his symptoms now and what might be the causes for high levels? He is going to have an ultrasound and has had a second blood test today. But I m concerned and confused [/INST] Hithe symptoms you are explaining is obviously due to the high bilirubin levels, or you can also call it jaundice. The bilirubin levels are produced due to the break-down of the red blood cells that is referred to hemolysis for which you have to do a lab test blood complete picture. Other than that there be an acute viral infection causing hepatitis resulting in increased hemolysis and hence increased production of bilirubin. It can also be due to some sort of obstruction in the common bile duct. The lab test bilirubin levels direct and indirect value can differentiate between obstructive and non-obstructive hyperbilirubinemia. The precautions you can follow is give him adequate fluids and better to admit him in nursing care hospital as he may require blue light therapy. Thanks with regards Chat Doctor.  </s>