Binding of Isaac: Rebirth Wiki

Added in Repentance

Tainted Lost is a character added in The Binding of Isaac: Repentance. It is the alternate version of The Lost The Lost. Tainted Lost is unlocked by reaching Home Home and using the Red Key Red Key, Cracked Key Cracked Key, or Soul of Cain Soul of Cain to access a special room in one of the walls while playing as the Lost.

Tainted Lost is just like the Lost but instead of Holy Mantle Holy Mantle, it starts with a Holy Card Holy Card and does not start with the Eternal D6 Eternal D6. Like the Lost, Tainted Lost has flight and spectral tears, but no health and dies from any damage taken. It also starts with a 1.3x damage multiplier, giving it higher starting damage and making most damage ups more powerful. Certain items will be automatically rerolled while playing as Tainted Lost, including most defense-oriented items (see Item Exclusion). To offset the lack of Holy Mantle Holy Mantle and limited defensive options, all cards that spawn have roughly a 10% chance of being turned into a Holy Card Holy Card.

Beating Delirium with The Lost The Lost is not required for Tainted Lost to obtain the Holy Card Holy Card, or for Holy Cards to spawn during the run.

As with The Lost, Devil Room Devil Room items and Black Market Black Market items can be taken for free but will be presented as a choice. Taking one item as a deal will cause the others in the room to disappear.

Item Exclusion[]

Tainted Lost has two mechanics that determine what items it can encounter.

Offensive items[]

The first mechanic makes it so that any items that are not tagged "offensive" cannot be naturally encountered while playing as Tainted Lost. This disallows items that it can't take advantage of, similar to The Lost The Lost's Birthright Birthright, but it also prevents many powerful defensive items, such as Dead Cat Dead Cat and Holy Mantle Holy Mantle, from naturally spawning. These items will be rerolled, and items that are set drops from mini-bosses (ex. Super Pride dropping Dead Cat Dead Cat) will never be dropped. Even Death Certificate Death Certificate will skip over disallowed items as they are generated.

Disallowed items can only appear by using Spindown Dice Spindown Dice, as set drops from props (ex. Dry Baby Dry Baby from a skull), or from Soul of Lilith Soul of Lilith.

Not all items tagged "offensive" are particularly offense-oriented items. Examples of this include Treasure Map Treasure Map and The D6 The D6.

Item quality[]

The second mechanic uses the item quality system. Items with a quality value of 2 or less have a 20% chance of being rerolled when encountered as Tainted Lost. The new item chosen is not guaranteed to have quality over 2.

Excluded Items[]

The following items cannot be found while playing as Tainted Lost.

Activated Collectibles[]

Name ID Icon Quote Description Quality
Blood Rights 5.100.186
Blood Rights
Mass enemy damage at a cost Upon use, takes a full heart of health and deals 40 damage to all enemies in the room. 0
Book of Revelations 5.100.78
Book of Revelations
6 rooms
Reusable soul protection Increases the chance of a Devil Room Devil Room / Angel Room Angel Room appearing while held. On use, gives one Soul Heart Soul Heart, and replaces the boss of the current floor with a Harbinger if possible. 3
Breath of Life 5.100.326
Breath of Life
6 seconds
Invincibility at a cost Grants a brief moment of invincibility when the charge bar hits zero. If the spacebar is held for an additional second after hitting zero, Isaac will take damage. 0
Converter 5.100.296
3 rooms
Convert your soul Removed in Repentance Converts two Soul Heart Soul Hearts or Black Heart Black Hearts into one filled Red Heart Red Heart Container.
Added in Repentance Converts one Soul Heart Soul Heart or Black Heart Black Heart into one filled Red Heart Red Heart Container.
Guppy's Paw 5.100.133
Guppy's Paw
Soul converter Upon use, converts one Red Heart Container into three Soul Heart Soul Hearts. 3
How to Jump 5.100.282
How to Jump
It's time you learned how Upon use, Isaac jumps in the direction he is currently moving, allowing travel over obstacles and enemies. 1
IV Bag 5.100.135
IV Bag
Portable blood bank Upon use, Isaac loses half a heart of health (or a full heart in Chapter 4 onward) for a random amount of coins, similar to a Blood Donation Machine. 1
Kamikaze! 5.100.40
Become the bomb! Creates an explosion around Isaac, damaging him and nearby enemies as well as destroying obstacles. 0
Prayer Card 5.100.146
Prayer Card
6 rooms
Reusable eternity Gives an Eternal Heart per use. 3
Razor Blade 5.100.126
Razor Blade
Feel my pain On use, takes one heart of health and grants +1.2 damage for the current room. 0
Satanic Bible 5.100.292
Satanic Bible
6 rooms
Reusable evil... but at what cost? Gives one Black Heart Black Heart. Added in Repentance Replaces the boss room item on the current floor with a Devil Deal. 4
The Jar 5.100.290
The Jar
Save your life When at full health, up to 4 extra Red Hearts can be stored in The Jar. Activating drops the stored hearts on the ground. 0
The Nail 5.100.83
The Nail
6 rooms
Temporary demon form Removed in Repentance Gives one Soul Heart Soul Heart. For the current room; +0.7 damage, -0.18 speed, Isaac breaks rocks and deals contact damage.
Added in Repentance Gives half a Black Heart Black Heart. For the current room; +2 damage, -0.18 speed, Isaac breaks rocks and deals contact damage.
The Poop 5.100.36
The Poop
1 rooms
Plop! Spawns a pile of poop where Isaac is standing and knocks back nearby enemies. May yield pickups like regular poop. 0
Unicorn Stump 5.100.298
Unicorn Stump
1 rooms
You feel stumped Gives invulnerability and increased speed for five seconds, but removes the ability to shoot tears. 1
Yum Heart 5.100.45
Yum Heart
4 rooms
Reusable regeneration Restores one full Red Heart Red Heart. 1
Clicker 5.100.482
6 rooms
Change Transforms Isaac into a random character and removes the last item collected. 0
Dull Razor 5.100.486
Dull Razor
2 rooms
I feel numb... Hurts Isaac without depleting health, activating any items that trigger upon taking damage. 1
Potato Peeler 5.100.487
Potato Peeler
A pound of flesh Removes a Heart Container, increases damage and range, and grants a Cube of Meat Cube of Meat. 2
Bag of Crafting 5.100.710
Bag of Crafting
Make your destiny Collects and holds up to 8 pickups, which can then be used to craft an item. The power level of the item is based on the quality of pickups used. 4
Spin to Win 5.100.655
Spin to Win
3 seconds
Let it rip! When used, gives Isaac +0.5 speed and greatly increases the rotation speed of Isaac's orbitals for 3 seconds. Gives Isaac a spinning top orbital that blocks enemy shots and deals contact damage to enemies while held. 1
Sumptorium 5.100.713
10 seconds
Blood to blood Removes half a heart and creates a Clot familiar that mimics Isaac's movements and tear effects. As Tainted Eve Tainted Eve, passively converts health into Clots while firing. Activating returns all Clots to health. 3
Yuck Heart 5.100.639
Yuck Heart
4 rooms
Gross! Gives Isaac a Rotten Heart. 2

Passive Collectibles[]

Name ID Icon Quote Description Quality
<3 5.100.15 <3 HP up Grants Isaac one Red Heart container and fully restores Isaac's health. 2
1up! 5.100.11 1up! Extra life Gives Isaac an extra life. Upon death, he will respawn in the most recent non-hostile room with full health, after which 1up! will disappear. 2
A Snack 5.100.346 A Snack HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional Red Heart Red Heart. 1
Anemic 5.100.214 Anemic Toxic blood Removed in Repentance +5 Added in Repentance +1.5 range. After Isaac is damaged, a trail of red creep will be left behind him until he leaves the current room. 1
Ankh 5.100.161 Ankh Eternal life? Upon death, Isaac will respawn as ??? ??? in the most recent non-hostile room, with 3 Soul Heart Soul Hearts. 1
Best Bud 5.100.274 Best Bud Sworn protector When hit, spawns a quickly orbiting attack fly similar to Forever Alone Forever Alone for the current room that deals high damage. 0
Big Fan 5.100.279 Big Fan Fat protector Spawns a large orbital familiar that blocks enemy shots and deals 30 damage per second to enemies. 2
Black Lotus 5.100.226 Black Lotus HP up x3! Grants one Red Heart, one Soul Heart, and one Black Heart. 2
Blood Bag 5.100.119 Blood Bag HP up Grants one Red Heart container, restores 5 Red Hearts, and increases speed by 0.3. 2
Bloody Lust 5.100.157 Bloody Lust RAGE! Increases Isaac's damage whenever he takes damage, up to six times. The bonus resets when entering a new floor. 3
Breakfast 5.100.25 Breakfast HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional Red Heart Red Heart. 1
Broken Watch 5.100.337 Broken Watch I think it's broken Chance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up. 1
Bucket of Lard 5.100.129 Bucket of Lard HP up Removed in Repentance Grants two empty Red Heart containers, heals Isaac by half a Red Heart, -0.2 speed.
Added in Repentance Grants two Red Heart containers, heals Isaac by half a Red Heart, -0.2 speed.
Cancer 5.100.301 Cancer HP up + you feel protected Adds 3 Soul Hearts. Grants The Wafer The Wafer effect for the current room after taking damage. 3
Celtic Cross 5.100.162 Celtic Cross Blessing of protection Grants a chance to trigger the Book of Shadows Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds. 1
Charm of the Vampire 5.100.62 Charm of the Vampire Kills heal Heals Isaac for a Half Red Heart Half Red Heart for every 13 enemies killed. Added in Repentance +0.3 damage. 1
Cube of Meat 5.100.73 Cube of Meat Gotta meat 'em all! Creates an orbital familiar. Collecting additional copies gives it the ability to shoot tears, then chase enemies to deal contact damage, then deal even more contact damage. 2
Dark Bum 5.100.278 Dark Bum He wants to take your life Spawns a familiar that follows Isaac around and collects Red Hearts. For every 1½ Red Hearts collected, Dark Bum will give a reward. 3
Dead Bird 5.100.117 Dead Bird Protective buddy After Isaac takes damage, spawns a flying familiar that chases enemies for the current room, dealing ~5 damage per second. 0
Dead Cat 5.100.81 Dead Cat 9 lives Sets Isaac's Red Heart Containers to 1, but grants 9 extra lives. After dying, Isaac respawns with 1 Red Heart Container. 3
Dead Dove 5.100.185 Dead Dove Flight + spectral tears Grants spectral tears and flight. 3
Dinner 5.100.23 Dinner HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional Red Heart Red Heart. 1
Dry Baby 5.100.265 Dry Baby Immortal friend Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon The Necronomicon effect. 3
E. Coli 5.100.236 E. Coli Turdy touch Enemies that touch Isaac are transformed into poop. 1
Fanny Pack 5.100.204 Fanny Pack Filled with goodies Has a chance to drop a random pickup when Isaac takes damage. 1
Fate 5.100.179 Fate Flight eternal Grants flight and one Eternal Heart Eternal Heart. 3
Gimpy 5.100.225 Gimpy Sweet suffering Gives chance of spawning a Soul Heart Soul Heart when taking damage. Enemies have a chance to drop a Half Red Heart Half Red Heart after being killed. 2
Gnawed Leaf 5.100.210 Gnawed Leaf Unbreakable After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots. 1
Guardian Angel 5.100.112 Guardian Angel Extra protection Spawns an orbital familiar that blocks enemy shots, deals 105 damage per second to enemies, and increases the speed of all orbital familiars. 2
Guppy's Collar 5.100.212 Guppy's Collar Eternal life? Grants a permanent 50% chance to respawn with 1/2 of a Red Heart after death. 2
Habit 5.100.156 Habit Item martyr When Isaac is hit, his active item gains 1 room's worth of charge. 2
Halo of Flies 5.100.10 Halo of Flies Projectile protection Spawns two Pretty Flies that block enemy shots and deal contact damage to flies. 2
Holy Grail 5.100.184 Holy Grail Flight + HP up Grants flight and one Red Heart container. 3
Holy Mantle 5.100.313 Holy Mantle Holy shield Grants a shield that negates the first instance of damage taken, once per room. Does not apply to or negate self-damage (Blood Donation Machine.png Blood Donation Machines, etc). 4
Infamy 5.100.242 Infamy Blocks damage... sometimes Chance to block projectiles coming from any direction. 2
Infestation 5.100.148 Infestation Fly revenge Removed in Repentance 1-3 Blue Flies randomly spawn every time Isaac gets hit.
Added in Repentance 2-6 Blue Flies randomly spawn every time Isaac gets hit.
Isaac's Heart 5.100.276 Isaac's Heart Protect it Isaac himself is now immune to all damage, and a heart familiar follows him. If the heart is hurt, Isaac is hurt. Added in Repentance The heart charges up as Isaac shoots, firing 8 blood shots, knocking back enemies, and leaving a puddle of creep when released. 0
Judas' Shadow 5.100.311 Judas' Shadow Sweet revenge Upon death, respawns Isaac as Dark Judas Dark Judas with two Black Heart Black Hearts in the most recent non-hostile room. 3
Lazarus' Rags 5.100.332 Lazarus' Rags Eternal life? Removed in Repentance Upon dying, resurrect as Lazarus Risen Lazarus Risen in the current room with one Red Heart container and Anemic Anemic.
Added in Repentance Upon dying, resurrect as Lazarus Risen Lazarus Risen in the current room with one less Red Heart container (but no less than 1), Anemic Anemic, and a permanent +0.5 Damage up. Going to the next floor reverts him back into Lazarus Lazarus, with his inherent extra life effect.
Leo 5.100.302 Leo Stompy Isaac can destroy rocks by walking into them. 1
Little C.H.A.D. 5.100.96 Little C.H.A.D. Gives kisses Spawns a familiar who drops a Half Red Heart Half Red Heart every 3 rooms. 2
Lord of the Pit 5.100.82 Lord of the Pit Demon wings Grants flight and +0.3 speed. 3
Lunch 5.100.22 Lunch HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional Red Heart Red Heart. 1
Maggy's Bow 5.100.312 Maggy's Bow HP up + you feel healthy Gives one Red Heart Container and doubles the healing provided by Red Heart Red Hearts. Added in Repentance Also heals 1 Red Heart when obtained. 2
Magic Scab 5.100.253 Magic Scab HP + luck up Grants one full Red Heart container, +1 luck. 2
Magneto 5.100.53 Magneto Item snatcher Pulls pickups towards Isaac. 1
MEAT! 5.100.193 MEAT! DMG + HP up Grants one full Red Heart container, +0.3 damage. 2
Missing Page 2 5.100.262 Missing Page 2 Evil up. Your enemies will pay! Grants one Black Heart. Upon taking damage that reduces Isaac's health to one heart or less, deals damage to all enemies in the room.
Added in Repentance Increases the damage of Black Hearts and The Necronomicon The Necronomicon-like effects by 40.
Mitre 5.100.173 Mitre Blessing of purity Grants a chance of converting any Red Heart pickups into Soul Hearts instead. 3
Old Bandage 5.100.219 Old Bandage HP up Grants an empty Red Heart container. Adds a chance of dropping a Red Heart after taking damage. 2
Ouija Board 5.100.115 Ouija Board Spectral tears Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them. 2
Piggy Bank 5.100.227 Piggy Bank My life savings Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny. 1
Placenta 5.100.218 Placenta Regeneration + HP up Grants one full Red Heart container, and a chance to regenerate a Half Red Heart of health every minute of gameplay. 2
Punching Bag 5.100.281 Punching Bag Scape goat Spawns a Mulligan familiar that wanders randomly. Enemies will attack the Mulligan if it's closer. 1
Pyromaniac 5.100.223 Pyromaniac It hurts so good +5 bombs +5 bombs. Grants immunity to explosion damage and causes explosions to heal Isaac. Added in Repentance Also grants immunity to fire. 4
Raw Liver 5.100.16 Raw Liver HP up Grants 2 Red Heart containers and completely restores health. 2
Rosary 5.100.72 Rosary Tears + faith up Grants 3 Soul Hearts. Causes The Bible The Bible to appear in any item pool. Added in Repentance +0.5 tears. 2
Rotten Meat 5.100.26 Rotten Meat HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional Red Heart Red Heart. 1
Sacrificial Dagger 5.100.172 Sacrificial Dagger My fate protects me Spawns a dagger orbital familiar, blocking enemy shots and dealing a high amount of damage to enemies in contact. 2
Samson's Chains 5.100.321 Samson's Chains The ol' ball and chain Attaches a ball and chain to Isaac that pulls behind him that damages enemies, blocks shots, and destroys most obstacles. 1
Scapular 5.100.142 Scapular Pray for a miracle Once per room, when Isaac is reduced to his last half heart, he is granted one Soul Heart. 2
Sharp Plug 5.100.205 Sharp Plug Infinite charge... at a cost Damages Isaac in exchange for fully recharging Isaac's current activated item. 1
Skatole 5.100.9 Skatole Fly love Flies become harmless or less dangerous depending on the type. 0
Smart Fly 5.100.264 Smart Fly Revenge fly Spawns an orbital familiar that blocks enemy shots. Upon taking damage, the familiar will pursue enemies for the rest of the room, dealing 22.5 damage per second. 2
Spiderbaby 5.100.211 Spiderbaby Spider revenge Removed in Repentance When hit, spawns 1-2 Blue Spiders.
Added in Repentance When hit, spawns 3-5 Blue Spiders.
Spirit of the Night 5.100.159 Spirit of the Night Scary Grants spectral tears and flight. 3
Stem Cells 5.100.176 Stem Cells HP + shot speed up Grants one full Red Heart container and +0.16 shot speed. 1
Stigmata 5.100.138 Stigmata DMG + HP up +0.3 damage, grants one full Red Heart container. Added in Repentance Heals 1 additional Red Heart Red Heart. 2
Stop Watch 5.100.232 Stop Watch Let's slow this down a bit... Removed in Afterbirth Automatically inflicts slow to all enemies in every room.
Added in Afterbirth / Removed in Repentance Upon taking damage, inflicts slow to all enemies for the current room.
Added in Repentance Slows all enemies in every room to 80% speed.
Super Bandage 5.100.92 Super Bandage +2 hearts Grants one full Red Heart container and 2 Soul Hearts. 2
Taurus 5.100.299 Taurus Speed down + rage is building -0.3 Speed. Isaac builds speed while in a room with enemies. At max speed, he gains the My Little Unicorn My Little Unicorn effect for 5 seconds. 1
The Black Bean 5.100.180 The Black Bean Toot on touch When taking damage, Isaac farts, causing poison damage to all enemies in range. 0
The Body 5.100.334 The Body I feel all Adds 3 Red Heart Containers. 3
The Ladder 5.100.60 The Ladder Building bridges Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections. 1
The Relic 5.100.98 The Relic Soul generator Spawns a cross familiar that drops a Soul Heart Soul Heart after clearing enough rooms. 3
The Soul 5.100.335 The Soul I am all Grants two Soul Hearts. Isaac gains a pulsing aura that repels enemies and projectiles. 3
The Virus 5.100.13 The Virus Poison touch + speed up Isaac poisons enemies on contact. Removed in Repentance -0.1 speed. Added in Repentance +0.2 speed. Added in Afterbirth / Removed in Repentance Poisoned enemies have a chance to drop a black heart when killed. 2
The Wafer 5.100.108 The Wafer Damage resistance All sources of damage that would cause more than one-half heart of damage are reduced to one-half heart instead. 4
Thunder Thighs 5.100.314 Thunder Thighs HP up + speed down + you feel stompy Destroys rocks upon contact with Isaac. Adds one Red Heart container and lowers Speed. 1
Transcendence 5.100.20 Transcendence We all float down here... Grants flight. 3
Trinity Shield 5.100.243 Trinity Shield You feel guarded Isaac gains a shield that protects him from enemy shots. It aims in the direction Isaac fires from. 3
Virgo 5.100.303 Virgo You feel refreshed and protected Adds a chance to give a shield that nullifies all incoming damage for 10 seconds upon taking damage. Also converts bad pills into good pills. 2
Athame 5.100.408 Athame Call to the void When Isaac takes damage, a black ring briefly appears around him, dealing damage to all nearby enemies. 1
Betrayal 5.100.391 Betrayal Turn your enemy Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac. 0
Cambion Conception 5.100.412 Cambion Conception Feed them hate After taking damage a certain amount of times, a permanent demonic familiar spawns. 2
Censer 5.100.387 Censer Peace be with you Spawns a familiar which creates a circular aura that slows down enemies and enemy shots inside. 3
Circle of Protection 5.100.423 Circle of Protection Protect me from myself Surrounds Isaac with a large white halo that occasionally deals Isaac's tear damage to enemies inside it, and can convert enemy shots into friendly homing tears. 2
Crack Jacks 5.100.354 Crack Jacks HP up. Don't swallow the prize! Grants one full Red Heart container and drops a random trinket. 2
Curse of the Tower 5.100.371 Curse of the Tower Embrace chaos Upon taking damage, spawns six Troll Bombs around the room, similar to the effect of XVI - The Tower XVI - The Tower. 1
Empty Vessel 5.100.409 Empty Vessel I reward an empty vessel Grants two Black Heart Black Hearts. While Isaac has no red hearts, grants flight and periodically grants an invincibility shield for a few seconds. 2
Farting Baby 5.100.404 Farting Baby He farts! Spawns a familiar that follows Isaac and blocks enemy shots. If a shot hits Farting Baby, it has a chance to fart, which charms, poisons, or knocks back nearby enemies. 1
Host Hat 5.100.375 Host Hat Blast resistance A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions. 3
Immaculate Conception 5.100.413 Immaculate Conception Feed them love Upon picking up a certain amount of health, spawn a permanent angelic familiar. 2
Milk! 5.100.436 Milk! Don't cry over it... Spawns a glass familiar that spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the current room. 1
My Shadow 5.100.433 My Shadow Me! And my shaaaadow! Each time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black friendly Charger that will attack enemies. The Charger will be killed if it is damaged too much. 0
Night Light 5.100.425 Night Light Scared of the dark? A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots. 2
PJs 5.100.428 PJs You feel cozy Grants 4 Soul Hearts and fully restores Isaac's health. 2
Sworn Protector 5.100.363 Sworn Protector Protective friend Spawns an orbital familiar which does 105 damage per second and attracts and blocks enemy shots. Upon blocking 10 shots in a room, it drops an Eternal Heart Eternal Heart. 3
Adrenaline 5.100.493 Adrenaline Panic = power Increases damage based on how many empty Red Heart containers Isaac has. 1
Blanket 5.100.535 Blanket You feel Safe Grants one Soul Heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears. 2
Bozo 5.100.513 Bozo Party time! +0.1 flat damage, grants a Soul Heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop. 2
Brittle Bones 5.100.549 Brittle Bones Everything hurts Replaces all Red Hearts with 6 empty Bone Hearts. Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a tears up. 3
Broken Modem 5.100.514 Broken Modem Lag! Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals. 2
Cone Head 5.100.457 Cone Head Hard headed! Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken. 2
Dad's Ring 5.100.546 Dad's Ring Father's blessing Creates a ring of light around Isaac that petrifies enemies in contact. 3
Dark Prince's Crown 5.100.442 Dark Prince's Crown Loss is power When at exactly one Red Heart, increases tears, range, tear height, and shot speed. 1
Greed's Gullet 5.100.501 Greed's Gullet Money = health! Grants a Red Heart container for every 25 coins Isaac has. 1
Hallowed Ground 5.100.543 Hallowed Ground Portable sanctuary Spawns a white poop familiar, which turns into a White Poop White Poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots. Added in Repentance The aura also increases damage b 20% and gives homing. 1
Leprosy 5.100.525 Leprosy You're tearing me apart! Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots. 1
Marbles 5.100.538 Marbles Choking hazard Spawns 3 random trinkets, 5% chance to swallow held trinket after taking damage, gaining its effect permanently. 2
Marrow 5.100.541 Marrow HP up? Grants one Added in Afterbirth † Bone Heart Bone Heart and spawns three Red Heart Red Hearts. 1
Metal Plate 5.100.449 Metal Plate It itches... Grants one Soul Heart. Enemy shots have a chance to be reflected at the shooter as confusing tears. 1
Midnight Snack 5.100.456 Midnight Snack HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional Red Heart Red Heart. 1
Mystery Egg 5.100.539 Mystery Egg Sacrificial insemination Spawns an egg familiar, which cracks into a random friendly monster when Isaac is hurt. The egg regenerates upon entering a different room. 1
Shard of Glass 5.100.448 Shard of Glass Blood and guts! Removed in Repentance Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.
Added in Repentance Taking damage causes Isaac to bleed, spraying a volley of blood in the direction he fires. Bleeding will eventually damage him, but it can be stopped by picking up a Red Heart Red Heart.
Slipped Rib 5.100.542 Slipped Rib Projectile shield Spawns a bone familiar that circles around Isaac and reflects enemy shots. 2
Varicose Veins 5.100.452 Varicose Veins I'm leaking... Taking damage releases a ring of 10 high damage tears. 2
2Spooky 5.100.554 2Spooky 4me Enemies near Isaac are afflicted with fear. 2
Astral Projection 5.100.677 Astral Projection The true out-of-body experience! Causes Isaac to turn into a ghost if he gets hit while in an uncleared room, giving him flight and spectral tears and blocking the next hit he takes. 2
Belly Jelly 5.100.690 Belly Jelly Bounce away! Causes enemies to bounce off of Isaac, dealing damage to them if they hit an enemy or obstacle. Also gives Isaac the chance to deflect enemy shots. 3
Binge Eater 5.100.664 Binge Eater All you can eat +1 Red Heart Container and fully heals Isaac. Item pedestals also offer a random food item. Picking up a food item temporarily grants +3.6 damage and permanently boosts 2 stats. 4
Bird Cage 5.100.610 Bird Cage Fat buddy The first time Isaac takes damage in a room, a familiar leaps on an enemy, dealing damage and releasing a rock wave. For the rest of the room, it chases enemies similar to Dead Bird Dead Bird. 1
Blood Oath 5.100.569 Blood Oath Bleed me dry Stabs Isaac at the beginning of each floor, draining his red hearts. Increases damage and speed for the floor based on the amount drained. 2
Bloody Gust 5.100.695 Bloody Gust May your rage bring haste The first 6 times Isaac takes damage on a given floor, he gains Speed and Tears for the rest of the floor, up to a maximum of +1.02 and +3.00, respectively. 3
Bot Fly 5.100.629 Bot Fly Defense drone Spawns an orbiting fly familiar that fires shielded tears at incoming enemy projectiles. 3
Candy Heart 5.100.671 Candy Heart Power of love Gives Isaac a permanent stat boost whenever he heals with Red Heart Red Heart pickups. 2
Cracked Orb 5.100.675 Cracked Orb Shards of knowledge Unlocks doors and reveals a random room on the map when Isaac takes damage. 1
Cube Baby 5.100.652 Cube Baby Kick it! Spawns an ice cube familiar that slides around when walked into. It slows and deals contact damage, freezing monsters it kills. 1
Divine Intervention 5.100.568 Divine Intervention Double tap shield Double tapping a fire key creates a shield that pushes away enemies and reflects enemy projectiles and lasers. 2
Empty Heart 5.100.676 Empty Heart It multiplies If Isaac has one red heart or less at the beginning of a floor, he gains an empty red heart container. 2
Giant Cell 5.100.658 Giant Cell Micro friends Causes Isaac to spawn micro-Isaacs when he takes damage, which chase and shoot at nearby enemies. 1
Heartbreak 5.100.694 Heartbreak Eternal sorrow Grants 3 broken hearts and +0.25 damage for every broken heart Isaac has. Every otherwise fatal hit will add 2 more until Isaac has nothing but broken hearts. 3
Hypercoagulation 5.100.724 Hypercoagulation Thick blooded After Isaac takes damage from an enemy or donates health, launches red hearts from Isaac that despawn after 1.5 seconds. 3
Inner Child 5.100.688 Inner Child Let him free Upon death, Isaac respawns in the current room with half of a Red Heart, a massive size down, and +0.2 Speed. 2
It Hurts 5.100.560 It Hurts No it doesn't... Releases a ring of tears and increases tears for the current room when Isaac takes damage. 1
Lost Soul 5.100.612 Lost Soul Protect him Creates a ghostly familiar that closely follows behind Isaac. It dies in one hit, but respawns at the start of the next floor. Each time it survives until the next floor, it rewards Isaac with Soul Heart Soul Hearts, Eternal Heart Eternal Hearts, or an Item. 2
Orphan Socks 5.100.571 Orphan Socks Speed up + your feet feel stronger Prevents creep and floor spikes from damaging Isaac. Also gives Isaac +0.3 speed and 2 Soul Heart Soul Hearts. 2
Psy Fly 5.100.581 Psy Fly Flamboyant protector Spawns a fly orbital familiar that chases and deflects enemy shots and converts them into homing tears that deal 2 damage. Turns some Fly enemies into friendly Blue Flies if it touches them while deflecting shots. 4
Sanguine Bond 5.100.692 Sanguine Bond He awaits your offering Spawns a special set of spikes in the Devil Room Devil Room. Taking damage from the spikes has a chance to grant a reward. 1
Spirit Shackles 5.100.674 Spirit Shackles Unfinished business On death, Isaac's ghost is chained to his dead body and he can continue to fight with 1/2 of a heart, returning to life after 10 seconds. After it activates, it must be recharged by picking up a Soul Heart Soul Heart. 2
Supper 5.100.707 Supper HP up Grants one full Red Heart container. Heals 1 additional Red Heart Red Heart. 1
The Swarm 5.100.693 The Swarm Infest Spawns eight orbital flies, which turn into Blue Flies after they block a shot. Each time a room is cleared, spawns another orbital fly. 2
Tinytoma 5.100.645 Tinytoma Itching for revenge Gives Isaac a Teratoma orbital that blocks shots, deals contact damage, and splits into smaller versions of itself upon taking damage. The smaller versions break into blue spiders. 1
Vengeful Spirit 5.100.702 Vengeful Spirit Hot blooded After taking damage, spawns an orbital wisp that lasts for the entire floor, up to a maximum of six. They fire tears but do not block shots. 2


With only a single Holy Card Holy Card for defense, defensive items become just as important as offensive ones, as you won't be able to afford taking more than a single hit the entire run unless you find another Holy Card. However, because all items not marked as "offensive" will automatically be rerolled, defensive options available are less plentiful.

A good way to secure a powerful run is to visit as many Boss Challenge Room Boss Challenge Rooms as possible. It is possible for the player to use the alternate floors to their advantage by sticking to the second floor of each chapter. By visiting Downpour Downpour II / Dross Dross II, the player can also get an extra boss item from the Mirrored World. This strategy comes with the added risk of having to fight more bosses, but provides the potential to snowball the players stats and make later floors much easier to survive in.

Good Items[]

These items provide significant benefits to Tainted Lost.

  • Ace of Spades Ace of Spades: Chance of changing the room drop reward to a card, and chance of getting a card as additional rewards from certain things, indirectly increasing the chance of getting a Holy Card.
  • Birthright Birthright: Grants an extra life, respawning in the same room and damaging nearby enemies.
    • This extra life item is the only one that can be naturally obtained as Tainted Lost, as all others are rerolled.
    • Summoning Birthright with Lemegeton Lemegeton will grant infinite lives until the wisp is destroyed.
  • Blank Card Blank Card: Allows a four charge reuse of the Holy Card.
    • 9 Volt 9 Volt and AAA Battery AAA Battery each reduce the charge time required by one bar.
    • The Battery The Battery allows storing an extra use of Blank Card, useful in case you take a hit multiple times in a short period.
  • Blanket Blanket: One-time Holy Mantle for boss battles. Keep in mind that Holy Card will take priority before Blanket if The Lost gets hit.
    • Blanket does not currently work in Greed/Greedier Mode when fighting boss battles.
  • Bone Spurs Bone Spurs: Especially useful against enemies that spawn bullets or other enemies on death as they will often be instantly blocked or damaged/killed, respectively.
  • Book of Shadows Book of Shadows: Very powerful in combination with Panic Button Panic Button, and allows infinite invincibility when fighting most endgame bosses if the player holds 4.5 Volt 4.5 Volt.
  • Book of the Dead Book of the Dead: The Bone orbitals spawned from this item can block projectiles, greatly increasing survivability,
  • Book of Virtues Book of Virtues / Lemegeton Lemegeton: Rings of wisps can block a lot of projectiles.
    • Summoning the Birthright Birthright wisp with Lemegeton will grant infinite lives until the wisp is destroyed.
  • Booster Pack Booster Pack: Has a fairly high chance of spawning a Holy Card.
  • Camo Undies Camo Undies: Allows Lost to be invisible upon entering a room and plan out their first attack.
  • Clear Rune Clear Rune: Can be used with Rune of Algiz Rune of Algiz. Similarly, Soul of the Lost Soul of the Lost can be used for a single-use Holy Mantle Holy Mantle for the current room.
  • Clicker Clicker: Becoming Tainted Lost by using Clicker allows Tainted Lost to keep all previously collected items. This allows many useful defensive items that Tainted Lost normally can't collect.
  • Coupon Coupon: Allows an extra item to be taken from devil deals.
  • Cursed Eye Cursed Eye: The downside of the item is inconsequential due to Tainted Lost's lack of health.
  • D1 D1 / D Infinity D Infinity /Dice Bag Dice Bag: Cards duplicated by D1's effect have an increased chance to be Holy Cards.
  • Damocles Damocles: The downside of the item is inconsequential due to Tainted Lost's lack of health.
  • Dark Arts Dark Arts: Provides a powerful panic button to escape swarms of enemies and/or bullets.
  • Deck of Cards Deck of Cards: Allows more chances of Holy Cards.
  • Echo Chamber Echo Chamber: The next three consumables used after Holy Card will grant another mantle.
  • Endless Nameless Endless Nameless: Has a 25% chance to spawn another Holy Card when one is used.
  • Flat File Flat File: Retracts almost all spikes and allows free Curse Room Curse Room entrance.
  • The Gamekid The Gamekid / My Little Unicorn My Little Unicorn: On-demand invincibility with contact damage.
  • Glass Cannon Glass Cannon: High damage shots that allow removal of especially dangerous enemies fast. The downside of the item is inconsequential due to Tainted Lost's lack of health.
  • Glowing Hour Glass Glowing Hour Glass: Allows recovery of a Holy Card shield.
    • Consuming Glowing Hour Glass with Void Void will result in a Void that doesn't lose its charges when activated, making it possible to repeat this process over and over.
  • Guppy's Tail Guppy's Tail can increase the amount of Locked Chest Locked Chests found in a run, and thus allows more chances for Holy Cards to appear.
  • Homing tears: Allows Tainted Lost to safely position himself almost anywhere in a room while still dealing damage.
  • Little Horn Little Horn / Euthanasia Euthanasia can destroy almost all "invulnerable" enemies (e.g. Poky Poky, Stone Grimace Stone Grimace) before they can hurt The Lost. Ball and Chain Ball and Chain are still invulnerable and dangerous.
  • Lost Contact Lost Contact: Blocks projectiles.
  • VI - The Lovers? VI - The Lovers?: Can be safely used to generate items with no loss of durability or risk of death.
  • Mercurius Mercurius / Door Stop Door Stop: Most rooms can be checked for a safe plan of attack, or bypassed entirely.
  • Missing Poster Missing Poster: Allows a one-time revival upon death, respawning Tainted Lost in the previous room.
  • Paschal Candle Paschal Candle: Lost's lack of health allows it to always stay at maximum level.
  • Pause Pause: Can be used with a damaging orbital such as Cube of Meat Cube of Meat, or Ball of Bandages Ball of Bandages to get lots of damage on bosses for free.
  • Perfection Perfection: +10 luck with no downside, and Tainted Lost's lack of health make losing it during the run impossible without an extra life. Luck-based tear effects such as Apple! Apple!, Tough Love Tough Love, Holy Light Holy Light, and Euthanasia Euthanasia benefit greatly from this extra luck, while also making sure Tainted Lost has a steady supply of pickups from room clear rewards.
    • Bird's Eye Bird's Eye and Ghost Pepper Ghost Pepper are exceptionally powerful combined with high luck: at 10 luck, every tear has a 50% chance to be accompanied by a powerful flame that blocks enemy projectiles. This becomes even more potent when both items are held, as all tears will fire one of these two flames at only 7 luck.
  • Placebo Placebo: Protective pills like Power Pill or Feels Like I'm Walking on Sunshine may be helpful.
  • Pluto Pluto: Smaller size makes you harder to hit.
  • Soul of Lazarus Soul of Lazarus: Acts as a suitable substitute to Holy Card.
  • Spindown Dice Spindown Dice: Allows Tainted Lost to obtain items otherwise hard-coded to not spawn for them.
  • Starter Deck Starter Deck: Increases the chances of finding Holy Cards and allows pill-generating items to spawn Holy Cards.
  • The Stairway The Stairway: Creates a ladder to an Angel Room Angel Room shop at the start of every floor, with the shop potentially selling powerful Angel Room Item Pool items and Holy Cards.
  • Telekinesis Telekinesis: Can be used to block projectiles or enemies.
  • Tooth and Nail Tooth and Nail: Timed invincibility allows exiting Curse Room Curse Rooms safely.
  • Uranus Uranus: Frozen enemies will not be able to spawn hazards (tears, explosives, other enemies) on death. Icicles from frozen enemies can also slow other enemies and potentially cause a chain reaction, freezing a whole group of enemies.
  • Wooden Cross Wooden Cross: A single-use Holy Mantle per floor. Note that it does not break before Holy Card, thus it is wise to save them for when the shield from Wooden Cross is broken.

Bad Items[]

These items provide significant drawbacks to Tainted Lost.

  • Any explosive tear effect, such as Fire Mind Fire Mind or Ipecac Ipecac, greatly increases the chance of fatal self-damage. Since Host Hat Host Hat and Pyromaniac Pyromaniac cannot naturally appear as Tainted Lost, there are very few ways to reliably avoid explosive self-damage.
  • Tear effects that destroy rocks (Sulfuric Acid Sulfuric Acid, Terra Terra) and the Stompy effect make firing from cover impossible – all but removing a safe method for Tainted Lost to attack non-flying enemies.
  • D4 D4 or D100 D100: Using either of these dice will result in your Holy Card protection being removed. Unlike The Lost, it does not come back upon entering a new room. A one pip Dice Room Dice Room will also give the same effect. Likely a bug.
  • Little Baggy Little Baggy: Holy Cards will no longer spawn.
  • IBS IBS: The effects of poop caused by damaging enemies is completely random which can lead to an unintended death or mantle loss.
    • Butt bombs may hurt you if you aren't paying attention, gas clouds from stinky poop could explode in a chain back to you if thrown at fires, and farts generate a gas cloud that will explode if you are next to a fire, leading to an untimely death.

Neutral Items[]

These items can provide both benefits and drawbacks to Tainted Lost.

  • Although items which provide temporary invincibility such as A Pony A Pony and Mars Mars can allow Tainted Lost to negate damage, their effects are difficult to time, and could result in charging into an enemy and being damaged.
  • Buddy in a Box Buddy in a Box: The familiar's potential tear effects are the same as Fruit Cake Fruit Cake, and as such have a small risk of carrying Fire Mind Fire Mind for a floor.
  • Dead Sea Scrolls Dead Sea Scrolls: Can cause items such as Anarchist Cookbook Anarchist Cookbook to trigger, potentially causing damage, but may also spawn a Holy Card via Deck of Cards Deck of Cards.
  • Experimental Treatment Experimental Treatment: HP is not a factor for Tainted Lost, so it may be included as one of the two stats which are reduced. However, it is more likely to be included as a stat increase, which has no effect.
  • Monster Manual Monster Manual: Can spawn Bob's Brain Bob's Brain or Lil Delirium Lil Delirium, which may cause unavoidable damage to the player. However, it can spawn many useful familiars too.
  • Number One Number One: Decreasing maximum range exposes Tainted Lost to danger, but increasing fire rate may make it easier to defeat enemies.
  • Teleport! Teleport! and Teleport 2.0 Teleport 2.0 can teleport Tainted Lost away from a dangerous room or before a fatal mistake is made. However, the player can teleport to a Curse Room Curse Room (or to a Secret Room whose only opened exit is a Curse Room) which is inescapable without a Holy Card.

Unlockable Items[]


  • While items like A Dollar A Dollar, Knife Piece 1 Knife Piece 1 and Knife Piece 2 Knife Piece 2 are not considered items that the Tainted Lost can find, they will still appear for him if the conditions for finding them are met.
  • While horsemen will still drop Cube of Meat Cube of Meat, C.H.A.D. C.H.A.D. will not drop Little C.H.A.D. Little C.H.A.D..
  • The achievement for unlocking Tainted Lost is "The Baleful", a possible title for the character.
    • "Baleful" means "ominous" or "harmful or malignant in intent or effect", possibly referring to how Tainted Lost has higher base damage than his regular counterpart and can find better items.
    • A more archaic meaning of "Baleful" is "Something/Someone wretched or miserable", and considering how Tainted Lost is incapable of using defensive heavy builds, being constantly at the mercy of enemies and dying usually at two hits, fit with this use of the word.
  • Before the 1.7.5 update, it was possible for Tainted Lost to find Yuck Heart Yuck Heart and Best Bud Best Bud, despite these items being useless for the character.
    • Additionally, Heartbreak Heartbreak could be found and utilized to essentially gain 4 extra lives and extra damage, but was removed from the tag list.
  • Tainted Lost's unlock drawing could be a reference to a transition nightmare Isaac can have, depicting The Lost talking to Mom Mom from the attic.
  • Tainted Lost unlocks 0 - The Fool? 0 - The Fool?, the character can be linked to both the numeration and meaning of the Fool.
    • The Fool's numeration can be either 0 the lowest trump or 22 the highest trump, linked to his attributes, better items, no mantle, no health, as Tainted Lost will die in a single hit at any point but also build the strongest runs than any other character because of those same attributes.
    • Reverse fool means apathy and nullity, it's the same approach often recommended to face Tainted Lost's runs because of how demanding the character is and easy to lose these runs despite how powerful.
    • In a literal reversal of "the beginning of the journey" which The Fool represent, Tainted Lost represents the complete end of Isaac's existence, after his own mortal remains has vanished and even his own soul erodes into dust and cobwebs along with the house and material objects that hold his last remanent memories.


Bug Bug! If Tainted Lost uses a Holy Card Holy Card, and then uses D4 D4, or another item / room which mimics it, the Holy Card mantle charge will be lost and he will die on the next damage taken.