High total bilirubin can be seen in physiological factors and disease factors such as hepatitis and cholelithiasis, while low total bilirubin can be seen in diseases such as aplastic anemia and iron deficiency anemia. Total bilirubin is the sum of direct bilirubin and indirect bilirubin, which is the product of destruction and decomposition of senescent red blood cells in the blood, and its elevation can be seen in physiological factors such as neonatal jaundice, and also in liver diseases such as acute hepatitis, chronic active hepatitis, cirrhosis, as well as extra-hepatic diseases such as cholelithiasis and obstructive jaundice. In addition, low total bilirubin can be seen in iron deficiency anemia, aplastic anemia, anemia due to chronic kidney disease and other disease states. It is advisable to visit a hospital for a doctor’s opinion on the cause of abnormal total bilirubin values.