Tainted 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 a 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. It also starts with a 1.3x damage multiplier, giving it higher starting damage and a higher efficacy for damage-increasing items. Randomly generated cards have roughly 10% chance of being turned into a Holy Card.

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

As with The Lost, Devil Room items and 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's Birthright, but it also prevents many powerful defensive items, such as Dead Cat and 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) will never be dropped. Even Death Certificate will skip over disallowed items as they are generated.

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

Not all items tagged "offensive" are particularly offense-oriented items. Examples of this include Treasure Map and 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	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 Room or Angel Room to appear after defeating the floor's boss, and sometimes/ always replaces the boss of the current floor with 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	Converts two one Soul Heart(s) or Black Heart(s) into one filled Red Heart Container.	2
Guppy's Paw	5.100.133	Soul converter	Upon use, converts one Red Heart Container into three Soul Hearts.	3
How to Jump	5.100.282	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	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
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 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 full Red Heart.	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.	2
Bag of Crafting	5.100.710	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
Flip	5.100.711	Twist of fate	Item pedestals have a second uninteractable "ghostly" item behind them. Activating will flip the real and ghostly items around. If playing as Tainted Lazarus, also flips between them and Dead Tainted Lazarus.	4
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	Blood to blood	Removes half a heart and creates a Clot familiar that mimics Isaac's movements and tear effects. As Tainted Eve, passively converts health into Clots while firing. Activating returns all Clots to health.	3
Yuck Heart	5.100.639	Gross!	Gives Isaac a Rotten Heart.	2

Passive Collectibles[]

Name	ID	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 most recent non-hostile room with full health, after which 1up! will disappear.	2
A Snack	5.100.346	HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Anemic	5.100.214	Toxic blood	Increases 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	Eternal life?	Upon death, Isaac will respawn as ??? in the most recent non-hostile room, with 3 Soul Hearts.	1
Best Bud	5.100.274	Sworn protector	When hit, spawns a quickly orbiting attack fly similar to Forever Alone for the current room dealing 75 150 damage per second.	0
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 one full Red Heart container. Heals 1 additional Red Heart.	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 full 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 after taking damage.	3
Celtic Cross	5.100.162	Blessing of protection	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. +0.3 damage.	1
Cube of Meat	5.100.73	Gotta meat 'em all!	Creates an Orbital Familiar which deals 105/ 56 contact damage per second and blocks enemy shots. 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	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	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
Dinner	5.100.23	HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	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 transformed into poop.	1
Fanny Pack	5.100.204	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.	2
Halo of Flies	5.100.10	Projectile protection	Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.	2
Holy Grail	5.100.184	Flight + HP up	Grants flight and one Red Heart container.	3
Holy Mantle	5.100.313	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 Machines, etc).	4
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. 2-6 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 follows him. If the heart is hurt, Isaac is hurt. 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	Sweet revenge	Upon death, respawns Isaac as Dark Judas with two Black Hearts in the most recent non-hostile room.	3
Lazarus' Rags	5.100.332	Eternal life?	Upon dying, resurrect as Lazarus Risen in the current room with one Red 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 additional Red Heart.	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. Also heals 1 Red Heart when obtained.	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
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 40 damage to all enemies in the room. Deals 80 damage, and increases the damage of Black Hearts and The Necronomicon-like effects by 40.	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	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	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	+5 bombs. Grants immunity to explosion damage and causes explosions to heal Isaac. Also grants immunity to fire.	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.	2
Rotten Meat	5.100.26	HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Sacrificial Dagger	5.100.172	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	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	Infinite charge... at a cost	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.	2
Spiderbaby	5.100.211	Spider revenge	When hit, spawns 1-2 Blue Spiders. When hit, spawns 3-5 Blue Spiders.	1
Spirit of the Night	5.100.159	Scary	Grants spectral tears and flight.	3
Stem Cells	5.100.176	HP + shot speed 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 80% 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 Soul	5.100.335	I am all	Grants two Soul Hearts. Isaac gains a pulsing aura that repels enemies and projectiles.	3
The Virus	5.100.13	Poison touch + speed up	Isaac poisons enemies on contact. -0.1 speed. +0.2 speed. Poisoned enemies have a chance to drop a black heart when killed.	2
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.	1
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
Censer	5.100.387	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	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	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	Embrace chaos	Upon taking damage, spawns six Troll Bombs around the room, similar to the effect of 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
Night Light	5.100.425	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	You feel cozy	Grants 4 Soul Hearts and fully restores Isaac's health.	2
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
Blanket	5.100.535	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	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	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	Lag!	Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.	2
Cone Head	5.100.457	Hard headed!	Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken.	2
Dad's Ring	5.100.546	Father's blessing	Creates a ring of light around Isaac that petrifies enemies in contact.	3
Dark Prince's Crown	5.100.442	Loss is power	When at exactly one Red Heart, increases tears, range, tear height, and shot speed.	1
Greed's Gullet	5.100.501	Money = health!	Grants a Red Heart container for every 25 coins Isaac has.	1
Hallowed Ground	5.100.543	Portable sanctuary	Spawns a white poop familiar, which turns into a white poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots.	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 Hearts.	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. Heals 1 additional Red Heart.	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.	1
Slipped Rib	5.100.542	Projectile shield	Spawns a bone familiar that circles around Isaac and reflects enemy shots.	2
Varicose Veins	5.100.452	I'm leaking...	Taking damage releases a ring of 10 high damage tears.	2
2Spooky	5.100.554	4me	Enemies near Isaac are afflicted with fear.	2
Astral Projection	5.100.677	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	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	All you can eat	+1 Red Heart Container and fully heals Isaac. Item pedestals cycle between their initial item and one of several food items, and picking up food items grants a temporary damage boost and a permanent boost to 2 stats (different for each one) in addition to their normal effects. Food items will also heal 2 additional Red Hearts when picked up.	4
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
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
Bloody Gust	5.100.695	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	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 Isaac a permanent stat boost whenever he 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
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
Empty Heart	5.100.676	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	Micro friends	Causes Isaac to spawn micro-Isaacs when he takes damage, which chase and shoot at nearby enemies.	1
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 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	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	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	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 Hearts, Eternal Hearts, or an item.	2
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.	2
Psy Fly	5.100.581	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	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
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. After it activates, it must be recharged by picking up a soul heart.	2
Supper	5.100.707	HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
The Swarm	5.100.693	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	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	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, defensive options available are less plentiful.

A good way to secure a powerful run is to visit as many 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 II / 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: 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: Grants an extra life, respawning in the same room and damaging nearby enemies.
Blank Card: Allows reuse of the Holy Card.
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: 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: Very powerful in combination with Panic Button, and allows infinite invincibility when fighting most endgame bosses if the player holds 4.5 Volt.
Book of the Dead: The Bone orbitals spawned from this item can block projectiles, greatly increasing survivability,
Book of Virtues / Lemegeton: Rings of wisps can block a lot of projectiles.
Camo Undies: Allows Lost to be invisible upon entering a room and plan out their first attack.
Clear Rune: Can be used with Rune of Algiz. Similarly, Soul of the Lost can be used for a single-use Holy Mantle for the current room.
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: Allows an extra item to be taken from devil deals.
Cursed Eye: The downside of the item is inconsequential due to Tainted Lost's lack of health.
D1 / D Infinity / Dice Bag: Cards duplicated by D1's effect have an increased chance to be Holy Cards.
Damocles: The downside of the item is inconsequential due to Tainted Lost's lack of health.
Deck of Cards: Allows more chances of Holy Cards.
Echo Chamber: Allows every consumable to be a Holy Card if one is used after obtaining.
Endless Nameless: Has a 25% chance to spawn another Holy Card when one is used.
Flat File: Retracts almost all spikes and allows free Curse Room entrance.
The Gamekid / My Little Unicorn: On-demand invincibility with contact damage.
Any luck-based tear effect such as Apple!, Tough Love, Holy Light, Euthanasia and Ghost Pepper benefits well from Perfection. One of the most powerful tear effect among them is Ghost Pepper: at 11 luck, every tear is accompanied by a blue spectral flame that deals heavy damage and blocks enemy projectiles.
Glass Cannon: High damage shots that allow to remove especially dangerous enemies fast. The downside of the item is inconsequential due to Tainted Lost's lack of health.
Glowing Hour Glass: Allows recovery of a Holy Card shield.
- Consuming Glowing Hour Glass with 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 can increase the amount of Golden Chests found in a run, and hence allows more chance for Holy Cards to appear.
Little Horn / Euthanasia can destroy almost all 'invulnerable' enemies, Poky and Stone Grimace before they can hurt The Lost. Ball and Chain are still invulnerable and dangerous.
Lost Contact: Blocks projectiles.
VI - The Lovers?: Can be safely used to generate items with no loss of durability or risk of death.
Mercurius / Door Stop: Most rooms can be checked for a safe plan of attack, or bypassed entirely.
Missing Poster: Allows a one-time revive upon death, respawning Tainted Lost in the previous room.
Paschal Candle: Lost's lack of health makes it always stay at maximum level.
Pause: Can be used with a damaging orbital such as Cube of Meat, or Ball of Bandages to get lots of damage on bosses for free.
Perfection: 10 luck with no downside, as Lost dies anyway if you get hit.
Placebo: Protective pills like Power Pill or Feels Like I'm Walking on Sunshine may be helpful.
Pluto: Smaller size makes you harder to hit.
Spindown Dice: Allows Tainted Lost to obtain items otherwise hard-coded to not spawn for him.
- Some incredibly useful Reroll chains for Tainted Lost include:
  - Belly Button to Cone Head
  - Book of Secrets to Blank Card
  - Contract From Below to Pyromaniac
  - Free Lemonade to Damocles
  - GB Bug to Farting Baby
  - Juicy Sack to Dry Baby
  - Meat Cleaver to Bot Fly to Death Certificate
  - Restock to Host Hat
  - Strange Attractor to Thunder Thighs to Holy Mantle
  - Tech.5 to Trinity Shield
  - Void to D1
  - We Need to Go Deeper! to The Nail to Lord of the Pit to Dead Cat
  - Lost Contact to Guppy's Collar to Spiderbaby to Gnawed Leaf
Starter Deck: Increases the chances of finding Holy Cards, and allows pill-generating items to spawn Holy Cards.
Sulfuric Acid and Terra can destroy Spiked Rocks without making explosions.
The Stairway: Creates a ladder to an Angel Room shop at the start of every floor, with the shop potentially selling powerful Angel Room Item Pool items and Holy Cards.
Telekinesis: Can be used to block projectiles or enemies.
Tooth and Nail: Timed invincibility allows exiting Curse Rooms safely.
Wooden Cross: A single-use Holy Mantle per floor. Note that it does not stack with Holy Card; it is thus wise to save Holy Cards for when the shield from the Wooden Cross is broken.

Bad Items[]

These items provide significant drawbacks to Tainted Lost.

D4 or 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 will also give the same effect. Likely a bug.
Little Baggy: Replaces Holy Cards with pills.
Fire Mind: Although tempting, it can cause unexpected explosions that can end a run in an instant. The lack of Host Hat and Pyromaniac deepens the risk.
BBF: The familiar can explode and kill the character.
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, ending your run prematurely.
Esau Jr. turns Tainted Lost into Esau Jr. without any hearts, which kills you instantly.

Fruit Cake and 3 Dollar Bill have the possibility to shoot Fire Mind tears.

Neutral Items[]

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

Although items which provide temporary invincibility such as A Pony and 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.
Dead Sea Scrolls: Can cause items such as Anarchist Cookbook to trigger, potentially causing damage, but may also spawn a Holy Card via Deck of Cards.
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: Can spawn Bob's Brain or Lil Delirium, which may cause unavoidable damage to the player. However, it can spawn many useful familiars too.
Teleport! and 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, which is inescapable without a Holy Card.

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.
While horsemen will still drop Cube of Meat, C.H.A.D. will not drop 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.
Before the 1.7.5 uptade, it was possible for Tainted Lost to find Yuck Heart and Best Bud, despite these items being useless for the player.

Bugs[]

Bug!	If Tainted Lost uses a Holy Card, and then uses 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.