Tainted Lost

 

No health

Stats

Damage	3.50 (* 1.30)
Tears	+0
Shot Speed	1
Range	6.5
Speed	1.0
Luck	0

Starting Items

Pickups	1 coin Holy Card
Items	Flight Spectral tears

Unlock Method
Use the Red Key or Cracked Key in Home as The Lost

Tainted Lost is a character added in The Binding of Isaac: Repentance. It is the alternate version of The Lost. Tainted Lost is unlocked by reaching Home and using either the Red Key or the Cracked Key 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, it starts with Holy Card and does not start with the Eternal D6. Tainted Lost has flight and spectral tears, but no health and dies from any damage taken. Cards and Runes have a 10% chance of being turned into a Holy Card.

Item Quality Bonus

Tainted Lost has an additional mechanic which prevents unusable and low-quality items from spawning, such as items that only provide health increases (which The Lost is unable to use)

Categorization and quality are hidden values assigned to each item in the game. If an item that does not qualify would be generated, it's instead silently rerolled to a suitable item.

Additionally, Tainted Lost has a 20% chance of rerolling any item with a quality value of 2 or less – such as Brother Bobby or Almond Milk – even if they would otherwise qualify.

This, unfortunately, precludes items such as Dead Cat and Holy Mantle. These cannot appear in game naturally (but will still appear through methods that force them to spawn, such as Spindown Dice).

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		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		Reusable soul protection	Gives one Soul Heart, increases the chance for a Devil or Angel Room, and changes the boss of the current floor to a Harbinger if possible.	3
Breath of Life	5.100.326		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		Convert your soul	Upon use, Converts two Soul Hearts into one full Heart Container. Upon use, converts one Soul or Black Heart into one full Heart Container.	1
Guppy's Paw	5.100.133		Soul converter	Upon use, converts one Heart Container into three Soul Hearts.	3
IV Bag	5.100.135		Portable blood bank	Upon use, Isaac loses half a heart of health (one in The Womb onward) for a random amount of coins, similar to a Blood Donation Machine.	1
Kamikaze!	5.100.40		Become the bomb!	Upon use, creates an explosion in the same place as Isaac, damaging him for half a heart and dealing 40 damage to all enemies caught in the blast.	0
Prayer Card	5.100.146		Reusable eternity	Gives an Eternal Heart per use.	3
Razor Blade	5.100.126		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		Reusable Evil... But at what cost?	Gives one Black Heart. Replaces the boss room item on the current floor with a Devil deal.	4
The Jar	5.100.290		Save your life	When at full health, up to 4 extra Red Hearts can be stored in The Jar.	0
The Nail	5.100.83		Temporary demon form	Gives one Soul Heart half a Black Heart. For the current room; +0.7 damage, -0.18 speed, allows Isaac to break rocks and damage enemies by walking over them.	3
The Poop	5.100.36		Plop!	Spawns a pile of poop where the Isaac is standing and knocks back nearby enemies. May yield pickups like regular poop.	0
Unicorn Stump	5.100.298		You feel stumped	Gives invulnerability and increased speed for five seconds, but removes the ability to shoot tears.	1
Yum Heart	5.100.45		Reusable Regeneration	Restores one Red Heart of Isaac's health.	1
Clicker	5.100.482		Change	Transforms Isaac into a random character and removes the last item collected.	0
Dull Razor	5.100.486		I feel numb...	Hurts Isaac without depleting health, activating any items that trigger upon taking damage.	1
Potato Peeler	5.100.487		A pound of flesh	Removes a heart container, increases damage and range, and grants a Cube of Meat.	3
Bag of Crafting	5.100.710		Make your destiny	Collects and holds up to 8 pickups. Holding the activate button crafts them into a passive item, with the power level based on the quality of pickups used.	3
Broken Glass Cannon	5.100.474		You broke it!	Begins with no charges and turns into Glass Cannon when used. Only acquired by taking damage while holding Glass Cannon.	0
Death Certificate	5.100.628		Where am I?	Takes Isaac to an abandoned and expanded version of Home, which has one copy of every item in the game. After taking an item, Isaac returns to the room he used Death Certificate in.	4
Flip	5.100.711		Life and death	Switch characters between Tainted Lazarus and Dead Tainted Lazarus.	3
Hold	5.100.715		Saved for later	Exclusive to Tainted ???. Allows him to save one poop bomb for later, allowing him to gather more over time.	0
Larynx	5.100.611		Hear my pain	Makes Isaac shout, damaging and pushing nearby enemies. The shout gets stronger the more charges the item has. Can also be charged by taking damage.	2
Recall	5.100.714		Come back	Retrieves the Forgotten's body from any distance. Only available as the Birthright effect for Tainted Forgotten.	0
Spin to Win	5.100.655		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		Return	Holding down the fire button converts hearts into familiars that fire tears but can be destroyed. Activating converts the familiars back into hearts.	3
Suplex!	5.100.709		Angel breaker	Allows Isaac to dash into and pick up enemies, then slam them into the ground to deal damage and create rock waves that damage nearby enemies and destroy obstacles.	3

Passive Collectibles

Name	ID	Icon	Quote	Description	Quality
<3	5.100.15		HP up	Grants Isaac one Red Heart container and fully restores Isaac's health.	2
1up!	5.100.11		Extra life	Gives Isaac an extra life. Upon death, he will respawn in the previous room with full health and lose the 1up!.	2
A Dollar	5.100.18		$$$	Gives Isaac 99 coins.	2
A Snack	5.100.346		HP up	Gives one full Red Heart container. Gives one Heart container and heals 2 hearts of health.	1
Anemic	5.100.214		Toxic blood	+5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.	0
Ankh	5.100.161		Eternal life?	Upon death, the player will respawn as ??? with 3 Soul Hearts.	2
Big Fan	5.100.279		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		HP up x3!	Grants one Red Heart, one Soul Heart, and one Black Heart.	2
Blood Bag	5.100.119		HP up	Grants one Red Heart container, restores 5 Red Hearts, and increases speed by 0.3.	2
Bloody Lust	5.100.157		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		HP up	Grants Isaac one full Red Heart container.	1
Broken Watch	5.100.337		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		HP up	Grants two empty Red Heart containers and heals Isaac by half a Red Heart, but decreases speed by 0.2.	1
Cancer	5.100.301		HP up + you feel protected	Adds 3 Soul Hearts. Grants The Wafer effect for the current room upon taking damage.	3
Celtic Cross	5.100.162		You feel blessed	Grants a chance to trigger the 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		Kills heal	Heals Isaac for half of a Red Heart for every 13 enemies killed.	0
Dead Bird	5.100.117		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		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		Flight + spectral tears	Grants spectral tears and flight.	3
Dessert	5.100.24		HP Up	Grants one full Red Heart container.	1
Dinner	5.100.23		HP Up	Grants one full Red Heart container. and 1 extra heart of health.	1
Dry Baby	5.100.265		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 effect.	3
E Coli	5.100.236		Turdy touch	Enemies that touch Isaac are changed into poop.	1
Fanny Pack	5.100.204		It's filled with goodies!	Has a chance to drop a random pickup when Isaac takes damage.	1
Fate	5.100.179		Flight eternal	Grants flight and one Eternal Heart.	3
Gimpy	5.100.225		Sweet Suffering	Gives chance of spawning a Soul Heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.	2
Gnawed Leaf	5.100.210		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		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		Eternal Life?	Grants a permanent 50% chance to respawn with 1/2 of a Red Heart after death.	2
Habit	5.100.156		Item Martyr	When Isaac is hit, his active item gains 1 room's worth of charge.	3
Halo of Flies	5.100.10		Projectile protection	Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.	3
Holy Grail	5.100.184		Flight + HP up	Grants flight and one Red Heart container.	3
Holy Mantle	5.100.313		Holy shield	Upon entering a room, grants a shield that negates the first damage taken.	4
Holy Water	5.100.178		Splash!	Spawns a bottle familiar that breaks when Isaac takes damage, leaving a puddle of blue creep. The bottle respawns upon entering a different room. A bottle familiar that flies forward when Isaac shoots. It breaks upon hitting an enemy, leaving a puddle of blue creep that petrifies enemies. The bottle respawns after a few seconds.	0
Infamy	5.100.242		Blocks damage... sometimes	Chance to block projectiles coming from any direction.	2
Infestation	5.100.148		Fly revenge	1-3 Blue Flies randomly spawn every time Isaac gets hit.	0
Isaac's Heart	5.100.276		Protect It	Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.	0
Judas' Shadow	5.100.311		Sweet revenge	Adds an extra life; upon death, it respawns Isaac as Dark Judas with two Black Hearts.	4
Lazarus' Rags	5.100.332		Eternal Life?	Upon dying, resurrect as Lazarus Risen with one heart container and Anemic.	1
Leo	5.100.302		Stompy	Isaac can destroy rocks by walking into them.	1
Little C.H.A.D.	5.100.96		Gives kisses	Spawns a familiar who drops a Half Red Heart every 3 rooms.	2
Lord of the Pit	5.100.82		Demon wings	Grants flight and +0.3 speed.	3
Lunch	5.100.22		HP Up	Grants one full Red Heart container. Heals 1 extra heart of health.	1
Maggy's Bow	5.100.312		HP up + you feel healthy	Gives one Red Heart container and doubles the healing provided by Red Hearts.	2
Magic Scab	5.100.253		HP + Luck up	Grants one full Red Heart container, +1 luck.	2
Magneto	5.100.53		Item snatcher	Pulls pickups towards Isaac.	1
MEAT!	5.100.193		DMG + HP up	Grants one full Red Heart container, +0.3 damage.	2
Midas' Touch	5.100.202		Golden touch	Enemies that touch Isaac are temporarily petrified and turn to gold. Any enemy killed while in this state will drop coins.	2
Missing Page 2	5.100.262		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. Increases the damage of Black Hearts and The Necronomicon from 40 to 80.	0
Mitre	5.100.173		Blessing of purity	Grants a chance of converting any Red Heart pickups into Soul Hearts instead.	3
Old Bandage	5.100.219		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		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		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		HP up + regen	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		Scape Goat	Spawns a Mulligan familiar that wanders randomly. Enemies will attack the Mulligan if it's closer.	1
Pyromaniac	5.100.223		It hurts so good +5 Bombs	Isaac heals 1 Red Heart instead of taking damage from an explosive source. Adds 5 bombs.	4
Raw Liver	5.100.16		HP up	Grants 2 Red Heart containers and completely restores health.	2
Rosary	5.100.72		Tears + faith up	Adds 3 Soul Hearts. The Bible will appear in any item pool. Also a +0.5 tears up.	1
Rotten Meat	5.100.26		HP up	Adds one full Red Heart container.	1
Sacrificial Dagger	5.100.172		My fate protects me	Spawns a dagger orbital familiar, dealing 225 damage per second and blocking enemy shots.	3
Samson's Chains	5.100.321		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		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		Charge with blood	Damages Isaac in exchange for fully recharging Isaac's current activated item.	1
Skatole	5.100.9		Fly love	Flies become harmless or less dangerous depending on the type.	0
Smart Fly	5.100.264		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.	3
Spiderbaby	5.100.211		Spider revenge	When hit, spawns up to 2 Blue Spiders.	1
Spirit of the Night	5.100.159		Scary	Grants spectral tears and flight.	3
Stem Cells	5.100.176		HP up	Grants one full Red Heart container and +0.16 shot speed.	1
Stigmata	5.100.138		DMG + HP up	Increases damage, and adds 1 heart container.	2
Stop Watch	5.100.232		Let's slow this down a bit...	Automatically inflicts slow to all enemies in every room. Upon taking damage, inflicts slow to all enemies for the current room. Slows all enemies in every room to roughly half speed.	4
Super Bandage	5.100.92		+2 hearts	Grants one full Red Heart container and 2 Soul Hearts.	2
Taurus	5.100.299		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 effect for 5 seconds.	1
The Black Bean	5.100.180		Toot on touch	When taking damage, Isaac farts, causing poison damage to all enemies in range.	0
The Body	5.100.334		I feel all	Adds 3 Red Heart containers.	3
The Ladder	5.100.60		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		Soul generator	Spawns a cross familiar that drops a Soul Heart every 5-6 rooms.	4
The Virus	5.100.13		Poison touch	Inflicts poison to enemies who make contact with Isaac. Speed down. Poisoned enemies have a chance to drop a black heart when killed.	0
The Wafer	5.100.108		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		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		We all float down here...	Grants flight.	3
Trinity Shield	5.100.243		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		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		Call to the void	When Isaac takes damage, a black ring briefly appears around him, dealing damage to all nearby enemies.	2
Betrayal	5.100.391		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		Feed them hate	After taking damage a certain amount of times, a permanent demonic familiar spawns.	2
Circle of Protection	5.100.423		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.	1
Crack Jacks	5.100.354		Don't swallow the prize!	Grants one full Red Heart container and drops a random trinket.	2
Curse of the Tower	5.100.371		Embrace chaos	Upon taking damage, spawns six Troll Bombs around the room similar to the XVI - The Tower.	1
Empty Vessel	5.100.409		I reward an empty vessel	Grants two 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		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		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		Feed them love	Upon picking up a certain amount of health, spawn a permanent angelic familiar.	1
Milk!	5.100.436		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		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
PJs	5.100.428		You feel cozy	Grants 4 Soul Hearts and fully restores Isaac's health.	2
Spider Mod	5.100.403		Mod buddy!	Displays Isaac's tear damage and enemy health bars. Spawns a familiar that wanders around and inflicts random status effects on enemies it touches. Can spawn a Lil' Battery/Blue spider upon clearing a room.	1
Sworn Protector	5.100.363		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.	3
Adrenaline	5.100.493		Panic = power	Increases damage based on how many empty Red Heart containers Isaac has.	1
Brittle Bones	5.100.549		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
Cone Head	5.100.457		Hard headed!	Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken.	2
Dark Prince's Crown	5.100.442		Loss is power	When at exactly one Red Heart, grants +0.75 tears, +1.5 range, +1 tear height, +0.2 shot speed.	1
Greed's Gullet	5.100.501		Money = health!	Grants a Red Heart container for every 25 coins Isaac has.	1
Leprosy	5.100.525		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		Choking hazard	Spawns 3 random trinkets, 5% chance to swallow held trinket after taking damage, gaining its effect permanently.	2
Marrow	5.100.541		HP up?	Grants one bone heart and spawns three red heart pickups.	1
Metal Plate	5.100.449		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		HP up	Grants one full Red Heart container.	1
Mystery Egg	5.100.539		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		Blood and guts!	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. 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.	0
Varicose Veins	5.100.452		I'm leaking...	Taking damage releases a ring of 10 high damage tears.	2
A Pound of Flesh	5.100.672		Blood money	Devil deals now cost coins, shop items now cost health, and consumables in shops are free but surrounded by spikes.	1
Astral Projection	5.100.677		The true out-of-body experience!	Causes Isaac to turn into a ghost if he gets hit while in a room with enemies, giving him flight and spectral tears and blocking the next hit he takes.	2
Belly Jelly	5.100.690		Bounce away!	Causes enemies to bounce off of Isaac, dealing damage to them if they hit and enemy or obstacle. Also gives Isaac the chance to deflect enemy shots.	2
Binge Eater	5.100.664		All you can eat	+1 red heart container and fully heals Isaac. Item pedestals cycle between their normal items and food, and collecting food grants a temporary damage boost and permanent bonuses to 2 stats.	3
Bird Cage	5.100.610		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.	1
Bird's Eye	5.100.616		It burns	Gives Isaac the chance to shoot fires alongside his regular tears that block enemy shots and deal damage to enemies that touch them.	2
Blood Oath	5.100.569		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
Blood Puppy	5.100.565		What a cute little thing!	Spawns a familiar that chases enemies. After killing enough enemies, it becomes more powerful and drops red hearts after killing enemies, but will also try to hurt Isaac. Attacking it returns it to normal.	2
Bloody Gust	5.100.695		May your rage bring haste	When Isaac takes damage, he gains speed and tears for the rest of the floor.	3
Bot Fly	5.100.629		Defense drone	Spawns an orbiting fly familiar that fires shielded tears at incoming enemy projectiles.	3
Candy Heart	5.100.671		Power of love	Gives permanent stat boosts when Isaac heals with red heart pickups.	2
Cracked Orb	5.100.675		Shards of knowledge	Unlocks doors and reveals a random room on the map when Isaac takes damage.	1
Cube Baby	5.100.652		Kick it!	Spawns an ice cube familiar that slides around when walked into. It slows and deals contact damage, freezing monsters it kills.	1
Dad's Note	5.100.668		...	Begins the sequence to access Home.	0
Divine Intervention	5.100.568		Double tap shield	Double tapping a fire key creates a shield that pushes away enemies and reflects enemy projectiles and lasers.	2
Dogma	5.100.633		Ascended	Grants flight, +0.1 speed, +2 damage, and the Holy Mantle effect. Grants enough health to have 6 full hearts, if possible. Automatically given to Isaac after defeating Dogma.	0
Empty Heart	5.100.676		It multiplies	If Isaac has an empty heart container, another one is added at the start of each floor.	2
Giant Cell	5.100.658		Micro friends	Causes Isaac to spawn micro-Isaacs when he takes damage, which chase and shoot at nearby enemies.	1
Guppy's Eye	5.100.665		An eye for secrets	Shows the contents of Chests, Sacks, and Fire Places before they're opened.	2
Heartbreak	5.100.694		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		Thick blooded	After taking damage from an enemy, launches a half or full red heart from Isaac that despawns after 1.5 seconds.	3
Inner Child	5.100.688		Let him free	Upon death, Isaac respawns in the current room with half a heart left, a massive size down, and +0.2 speed.	3
It Hurts	5.100.560		No it doesn't...	Releases a ring of tears and increases tears for the current room when Isaac takes damage.	1
Knife Piece 1	5.100.626		???	Combined with Knife Piece 2, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Knife Piece 2	5.100.627		???	Combined with Knife Piece 1, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Lost Soul	5.100.612		Protect him	Gives Isaac a soul familiar that dies in one hit, respawning at the start of the next floor. If it survives an entire floor, it rewards Isaac with hearts or items.	2
Mucormycosis	5.100.553		Spore shot	Gives Isaac the chance to fire spore tears that stick to enemies and blow up after a few seconds, dealing damage and poisoning nearby enemies and releasing more spores.	3
Orphan Socks	5.100.571		Speed up + your feet feel stronger	Prevents creep and floor spikes from damaging Isaac. Also gives Isaac +0.3 speed and 2 soul hearts.	1
Purgatory	5.100.634		Help from beyond	While in a room with enemies, spawns cracks on the ground. Walking over these cracks summons ghosts that launch themselves at enemies and explode.	2
Sanguine Bond	5.100.692		He awaits your offering	Spawns a special set of spikes in the Devil Room. Taking damage from the spikes has a chance to grant a reward.	1
Soul Locket	5.100.686		Power of faith	Gives Isaac a permanent stat boost whenever he picks up a soul heart.	2
Spirit Shackles	5.100.674		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. Must be recharged by picking up a soul heart.	3
Strawman	5.100.667		A helping hand	Spawns Keeper to fight enemies alongside Isaac. If Keeper dies, he spawns blue spiders and Strawman is removed from Isaac's inventory.	2
Supper	5.100.707		HP up	Grants one Red Heart container and heals for one extra heart.	1
The Swarm	5.100.693		Infest	Spawns nine 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		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
Vanishing Twin	5.100.697		He wants revenge	Spawns a familiar that becomes a clone of the floor's boss when entering the boss room. Defeating it drops an extra item.	3
Vengeful Spirit	5.100.702		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

Strategy

With only a single 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, the amount of defensive options available are much less plentiful. Some of the most important items that can't spawn due to this mechanic are:

• Gnawed Leaf
• Unicorn Stump
• 1up!
• Pyromaniac
• Host Hat
• Stop Watch
• Guppy's Collar
• Taurus
• Inner Child (Although he can still obtain the version of this item in the closet in The Home)

Not all good defensive items are removed by this mechanic, however; after all, the best defense you can have as Tainted Lost is a great offense, and there will be no shortage of good offensive items if you're playing as him. But in terms of actually defensive items, here are some that should be sought out when restarting or going through your run:

• Blank Card (to re-use Holy Card)
• Book of Shadows (very powerful in combination with Panic Button)
• Deck of Cards (for cards to get you out of bad situations, plus the chance to get another Holy Card)
• My Little Unicorn
• The Gamekid
• The Soul
• Lost Contact
• The Hourglass
• Flush!
• Glowing Hour Glass (to recover your shield after getting hit)
• Mom's Box (to get Wooden Cross)
• Censer
• Placebo (if used with Power Pill or Feels Like I'm Walking on Sunshine)
• Book of the Dead
• D1 (to duplicate your starting Holy Card)
• Pause
• Camo Undies
• Dad's Ring
• Slipped Rib
• Bloodshot Eye
• Telekinesis
• Blanket
• Book of Virtues
• Clear Rune (to use with Rune of Algiz)
• Dark Arts
• Jar of Wisps
• Lemegeton
• Birthright (Gives an extra life as Tainted Lost)
• Mercurius
• Pluto
• Psy Fly
• Tooth and Nail
• 2Spooky
• Anima Sola

Unlockable Items

• 

  Kid's Drawing - Defeat Isaac, ???, Satan and The Lamb as Tainted Lost.

• 

  The Fool - Defeat Ultra Greedier as Tainted Lost.

• 

  Soul of the Lost - Defeat Hush and Boss Rush as Tainted Lost.

• 

  Haunted Chest - Defeat Mega Satan as Tainted Lost.

• 

  Ghost Bombs - Defeat Delirium as Tainted Lost.

• 

  Crystal Key - Defeat Mother as Tainted Lost.

• 

  Sacred Orb - Defeat The Beast as Tainted Lost.

Trivia

• While items like A Dollar, Knife Piece 1 and 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.
• The achievement for unlocking Tainted Lost is "The Baleful", a possible title for the character.

Birthright effect

Gives the Lost an extra life, if killed all enemies near him will take 200 damage, enemies can be hit multiple times.

Characters
Rebirth Afterbirth Afterbirth † Repentance Tainted