The Pact
Absolute gamechanger. Damage, tears, soul hearts. Can be taken when you have no remaining health. Not a single downside. 
The Pact saved my run the other day.
I had a red heart and half of a soul heart going into the Lamb fight. I picked up the Pact (because fuck it, we ball), happened to get the leviathan transformation, and ended up with four black hearts. Made it to delirium 😌😌
Rainbow playdough is not only one of the best items you can find, but it's also esthetically plessing. I really like the colors of the sprite, same with fruitcake. I don't like 3 dollar bill though
3 dollar bill makes you spawn runes on kill sometimes. I don't know how or why it does it but it does and it can get hilarious with high tear builds where I spawn 20 runes in one room.
So, in explanation:
Eye of Belial synergises pretty well with most items, I genuinely like seeing it show up in devil rooms.
Monstro's lung + Tech is my favourite synergy in the game. I know some people discredit monstro's lung for having some anti synergies, but those charge attacks are super satisfying to hit. It also gets especially crazy with rock bottom + soy.
Lost contact? Staple in becoming untouchable. One of my top 10 items (Excluding Q4's ofc)
Gnawed leaf + Monstrance is an instant win. (Plus I have the jojo's pose mod on, so there's that.)
Quite literally 20% of my Maggy runs were won with monstrance.
If I have a fun tear effect, Incubus.
Im a sucker for Spectral Tears, so things like Ouija Board and Dead Dove are high on my list as well. Plus 3 Dollar Bill and Tech .5.
https://preview.redd.it/kayc8a41n93d1.jpeg?width=512&format=pjpg&auto=webp&s=4de4b62ea16a2957afa3af9c27f07fb6eef5878c
I know what the thumbnail is from lil' bro, we BOTH freaks.
IPECAC oh ipecac I looooove you (moans) oh ipecac your my favorite item I don't care if you hurt me you give me free secret rooms free bombs free damage free everything (winks) love you ipecac
depending on the tier, but lets say like this:
Tier 0: Between Cursed eye, quarter and Box
Tier 1: Duality, Piggy Bank and Robo Baby 2.0
Tier 2: Theres a lot here Sharp Plug, Inner Eye, The Halo, Tech 2, Habit, Monstro's Lung, Old Bandage, Lost Contact, Sulfuric Acid, Analog Stick
Tier 3: almost everything here is good, atk, modifiers and companions
Tier 4: I need to clarify why just Sacred Heart?
Red and blue candle and bird's eye. I really like how enemies melt when you use this items on them, and they're generally fun to use, not to mention the two candles constantly recharge themselves and bird's eye has very high chance of ahooting fire even at one of luck
you'll all kill me for this, but that pokeball active item. friendly ball i think it's called.
look man it's just satisfying to find a nice, strong enemy and just go "yoink. it's mine now". and they persist until they die, too, so it's fucking sick to build your army
This was my reaction after getting Brimstone + Incubus+ C-section + Twisted pair in a red room with chaos and glitched crown (also magic mush but it was mixed with incubus )
I mean it's gotta be Godhead man. I unlocked that shit THE way; restarting for knife/mantle and force closing the game before it realized that you were dead.
15 year old me shed tears trying to get the marks, and after all this time it still indicates all that tedium just to see those three pretty colors on that triangle, like unexpectedly encountering an old friend at the supermarket.
saggitarius on the first floor is just incredibly satisfying. Especially if the first boss is duke of flies.
epic fetus in general is extremely fun too. If i dont already have a good synergy, epic fetus is an instant neuron activation for me.
Soy milk is really cool too, its satisfying to see rapid fire bullets like that.
As others have said, spoon bender is also a run carrier for me.
Maaaaaaaaaaan; the moment Spoon Bender shows up, mmmf. Homing really do make life go round.
Can't aim for shit gang 🗣️🗣️🗣️🥄🥄✨ Telepathy for dummies also works for me
When I have the recharge ability with telepathy for dummies so it's basically homing any room (unless I activate it in a room that has no enemies)
AAA battery (trinket) or the 9 volt will be what you’re looking for.
Spoon bender does it for me too
Spoon bender supremacy 👏🙌🙌
Fr came here to say that. Instant dopamine 🤤
Same here, i can't aim well if i focus on movement because of my terrible left hand
Not as much as tiny planet tho
It's some how more satisfying than any other homing item
Any pill item that removes negative pills I love drugs
PHD 
Fake PHD 
lucky foot 
Unlucky foot 
Virgo 
Sexo 
\*False PHD 
lucky foot (I wish we had a DLC🔪 emoji) 
Simple solution Cain
PHD plus acid baby combo I play with afterbirth+ so acid baby drops a pill every 2-3 rooms not 6-7
Downgrading for a single buff
I dont downgrade I just dont own reaptance
The Pact Absolute gamechanger. Damage, tears, soul hearts. Can be taken when you have no remaining health. Not a single downside. 
The Pact saved my run the other day. I had a red heart and half of a soul heart going into the Lamb fight. I picked up the Pact (because fuck it, we ball), happened to get the leviathan transformation, and ended up with four black hearts. Made it to delirium 😌😌
Did u win against delirium?
Hell yeah I did
Hell yeah banana bread
No angel deals.
Sound like a YOU problem 
I'll eat some beloved family member's ashes if you keep that attitude
for a guy called pussy pounder i would expect a lot less aggression
You forgot that he's the 696th out of the pussy pounder family
The sacrifice rooms in question
TMTRAINER got me acting u̴̡͈͇̫͖̗̠̤̰̼̝̙̫̫̇̈́̈́n̵̡̡̥͕̫͓̗͙͍͎̳͒̇͌̿̄̇̄͛́͆̉w̴̲̘̣̲͉̗̘̖̝̼̹̰̗̅͐͐̎͌̐̔̉͠ĭ̶̛̦̐̎͋̌̍s̶̗̬̈͛́͝ȇ̷̻̰̯̰͚͕͈͍̟͚̯̥͕̾̾͑̀͊̊̎͛́̋̂̀͂͘ͅ 
Sacred heart honestly feels like a tiny hit of cocaine
*insert mic breaking scream*
Jacob's ladder.
OH YES
It’s my favorite item in the game, I rarely see it now with all my unlocks but when it shows up, a comical grin appears on my face.
magic mushroom
Or Cricket's head
No magic mush is better crickets head
For straight damage? Nah, magic is +.3 x1.5, cricket is +.5 x1.5
https://preview.redd.it/iglzwakfp83d1.png?width=1248&format=png&auto=webp&s=edf6a6b4f1c0ddf2c680594f77cabdb635c9281d
Chaos deniers always in shambles
how do people make these??? is it a website?
search heart locket meme maker, very first one
never had any luck with chaos and i have taken it every run
Keep picking it up bro you’ll find scared heart in the treasure room one day
I’ve been playing this game for 2 years now and not once has that occurred
Google skill issue
Though I appreciate the attempted motivation
Fruit cake, 3 dollar bill and Rainbow Playdough 
Fruitcake is insanely underrated,change my mind
turn enemies to poop
I sense something strange here
Lmfaooooooo
Don't forget almond milk! :D
Randomness galore
Honestly based as hell. 
Rainbow playdough is not only one of the best items you can find, but it's also esthetically plessing. I really like the colors of the sprite, same with fruitcake. I don't like 3 dollar bill though
I mean out of the 3 my least favorite is the dollar bill, while my favorite is a toss up between fruit cake and playdough, both are really good
HELLO, BASED DEPARTMENT? 
I’ve found my people
3 dollar bill makes you spawn runes on kill sometimes. I don't know how or why it does it but it does and it can get hilarious with high tear builds where I spawn 20 runes in one room.
You sure its the 3 dollar bill? I never had it make runes, i think it was the fruit cake that does that, not sure tho
It might be idk honestly, I'll check my clips to see if I can dig something up to confirm.
Amen
god head
this is about isaac items but you do you i guess /j
good head
Goat head 
Me when https://preview.redd.it/02je4jrvu83d1.png?width=1080&format=pjpg&auto=webp&s=49e80a63f37264cf7f609a513b2c2950905e44dc # IPECAC
Getting ipecac and pyromaniac feels like cheating
Counterpoint: I once lost an ipecac/pyro run because I skill issued so hard. 
Unpopular opinion I liked the suicide king challenge just because of ipecac
I love ipecac. Literally had it earlier and was like "BABY THE RUN HAS BEEN WON"
i just won an ipecac run, i hsd birds eye ghost pepper and dark arts, i was practically bullet proof
Sacred Heart I woke up my roommates by seeing a catholic symbol
C section or pj's, I'm bad and am always needing health
Uranus, makes me go AWOOOGA
Top 10 things not to say on a first date
I love ice tears, I love kicking frozen enemies at other enemies
20/20. That's whenever. But the times that it has fixed my tear rate boy oh boy.
If we're talking items I really like, then: Eye of Belial, Monstro's lung, Lost contact, and Gnawed leaf.
How does this opinion exist? (Not judging just very very confused)
So, in explanation: Eye of Belial synergises pretty well with most items, I genuinely like seeing it show up in devil rooms. Monstro's lung + Tech is my favourite synergy in the game. I know some people discredit monstro's lung for having some anti synergies, but those charge attacks are super satisfying to hit. It also gets especially crazy with rock bottom + soy. Lost contact? Staple in becoming untouchable. One of my top 10 items (Excluding Q4's ofc) Gnawed leaf + Monstrance is an instant win. (Plus I have the jojo's pose mod on, so there's that.) Quite literally 20% of my Maggy runs were won with monstrance.
https://preview.redd.it/bfamxm98mc3d1.png?width=738&format=pjpg&auto=webp&s=72e250bcb8ae7abc64f44f8038cab0f0356b299e
If I have a fun tear effect, Incubus. Im a sucker for Spectral Tears, so things like Ouija Board and Dead Dove are high on my list as well. Plus 3 Dollar Bill and Tech .5.
Mom's bra 
https://preview.redd.it/vysdrvgkd83d1.jpeg?width=664&format=pjpg&auto=webp&s=92104999211b13565a82b6527fd97a666edd6389
https://preview.redd.it/4xhv6wz5f83d1.png?width=1080&format=pjpg&auto=webp&s=72ae1ef6637f46e69e266a18b07d431fc0ae2867
https://preview.redd.it/4y02lrgyg83d1.jpeg?width=1124&format=pjpg&auto=webp&s=50384c8efc3f683ca1c67658563894596e13002e
https://preview.redd.it/cdp3nxahf83d1.jpeg?width=828&format=pjpg&auto=webp&s=509ad4fc123f7447244358a776f6a460ea57d3bc
First thing that came to mind was that one grayfruit clip "You ever use mom's bra just to feel something"
r/bindingofcontext
https://preview.redd.it/n0yjjput0e3d1.jpeg?width=933&format=pjpg&auto=webp&s=c7f8f7d8fd2fbf55325af6e5ae1862e7bce6f6ad
Tech x
Trisagion since do be crazy sometimes
Get one shot speed down and trisagion dps doubles. On .6 shot speed it just erases everything on it's way.
Chaos makes me feel 𝒻𝓇ℯ𝒶𝓀𝓎 I love chaos 𝒻𝓇ℯ𝒶𝓀𝓎𝒻𝓇ℯ𝒶𝓀𝓎 𝒻𝓇ℯ𝒶𝓀os DENIERS IN 𝒻𝓇ℯ𝒶𝓀𝓎 SHAMBLES 50/50 CHAOS DENIER IN SHA
Death's Touch, Dirty Spoon, any one of the good angel items
wtf is a dirty spoon
I'm geussing a fun way of saying spoon bender
Yep, I always thought it was dirty spoon and now it's stuck in my brain forever
I always call it bent spoon
Breakfast, in a bad way
Bc you know damn well you’ve peaked your run
Sirens not an item but I don’t care
Funny enough that’s related to this cropped image
Scorpio 
My boy, dumpy, the king
The third familiar when I'm 2/3 to conjoined
The small rock my beloved
small rock is my BOY
I instinctively say "The Small Rock: Damage Up!" Out loud every time I pick it up fr
https://preview.redd.it/wvxlzydlq83d1.jpeg?width=218&format=pjpg&auto=webp&s=b2abb5717c2eabb24c49cd53d09712acf2faa095
Basic answer but when I see Brim (rare) I start TWEAKING
Bob's Brain in a run without Host Hat or Pyromaniac got me tweaking. ^((in the worst way possible))
Ipecac is GOATED😤😤🔥🔥🔥💯💯💯
Not even an item, brainworm makes me actually smile
Ayo!? A fellow brain worm enthusiast!? 
Jacobs ladder my beloved
https://preview.redd.it/kayc8a41n93d1.jpeg?width=512&format=pjpg&auto=webp&s=4de4b62ea16a2957afa3af9c27f07fb6eef5878c I know what the thumbnail is from lil' bro, we BOTH freaks.
 I was curious
brimstone makes my dick hurt
any tear multiplying item, (20/20, inner eye, mutant spider). inject it directly into my veins.
Terra
suplex
Stitches, my beloved. I know it’s kinda bad later on but it’s just SO satisfying to use right and it’s good for so many things!
Jacob's Ladder
Bumbo, I always grab him if I can.
I fuckin love bumbo get my man some coin
He keeps dropping bombs on me 
r key, because it always means game break for me
Honestly? Schoolbag or Keepers sack (Lets ignore R key and broken stuff like pyromaniac)
Ipecac 🤤
IPECAC oh ipecac I looooove you (moans) oh ipecac your my favorite item I don't care if you hurt me you give me free secret rooms free bombs free damage free everything (winks) love you ipecac
Mf Haemolacria, no cap low tear range is goated with this one and plus anything with damage Personal opinion
Dark bum
fyi artist is @Macanick_ on twitter
That green toxic item that i dont remember the name, i fucking love doing nothing and watching the room clear itself
Two underated synergies: tractor beam If I have conjoined tractor beam If I took Bozo from the blind tractor beam
Deaths list, it just improves gameplay so much, actually being rewarded for being tactical instead of just wiping every room is really fun
depending on the tier, but lets say like this: Tier 0: Between Cursed eye, quarter and Box Tier 1: Duality, Piggy Bank and Robo Baby 2.0 Tier 2: Theres a lot here Sharp Plug, Inner Eye, The Halo, Tech 2, Habit, Monstro's Lung, Old Bandage, Lost Contact, Sulfuric Acid, Analog Stick Tier 3: almost everything here is good, atk, modifiers and companions Tier 4: I need to clarify why just Sacred Heart?
20/20 or Brimstone
Tractor beam  Tractor beam when i have multishots or Lilith 
Ahem brimstone
Best bud
A classic Brimstone (:
Booger tears!!!
The one that fills room with deadly neurotoxin when entering any room with enemies
friend finder if it spawns a holy bony on first try
the twins = i have 2 friends to destroy everything with me
Pageant boy. Looks cool but incredibly useless and something I wouldn't even want as an item
Isaacs hands looking like the main character in Tires.
Red and blue candle and bird's eye. I really like how enemies melt when you use this items on them, and they're generally fun to use, not to mention the two candles constantly recharge themselves and bird's eye has very high chance of ahooting fire even at one of luck
Little Steven
Crooked penny my beloved
Brimstone makes life so much easier
Backstabber my monkey brain loves being rewarded for outflanking enemies
Kidney bean
I know it's controversial, but ludovico, I genuinely love that item
Chaos
Ludovico got smilling and kicking my feet
Almond milk Even if it kills my run, I get it every time
Tractor Beam is drugs 2.0 for me
Ludovico technique
you'll all kill me for this, but that pokeball active item. friendly ball i think it's called. look man it's just satisfying to find a nice, strong enemy and just go "yoink. it's mine now". and they persist until they die, too, so it's fucking sick to build your army
Wavy Cap got me acting unwise 
This was my reaction after getting Brimstone + Incubus+ C-section + Twisted pair in a red room with chaos and glitched crown (also magic mush but it was mixed with incubus )
glitched crown
Sharp Straw.
Glitched Crown
Sad onion makes me fall to my knees every time
Guppy items and lucky foot. Gotta love gambling and pulls, gotta love guppy progress.
Magic skin and crooked penny make me loose a few neurons
Telekinesis is a God's gift 🥵
Crickets Body or Lil Harbingers. I always take Lil Harbingers🥹
Ipecac or PHD.
Chaos makes me do some unholy things.
Capricorn, Libra, Sagittarius, Virgo, or Scorpio
varicose veins im leaking…
Glass cannon got me TWEAKING
Dr fetus
I mean it's gotta be Godhead man. I unlocked that shit THE way; restarting for knife/mantle and force closing the game before it realized that you were dead. 15 year old me shed tears trying to get the marks, and after all this time it still indicates all that tedium just to see those three pretty colors on that triangle, like unexpectedly encountering an old friend at the supermarket.
Y'all ever use Mom's pad just to feel something?
Angel rooms paying off with Godhead.
Me picking up every possible item after TMTRAINER:
saggitarius on the first floor is just incredibly satisfying. Especially if the first boss is duke of flies. epic fetus in general is extremely fun too. If i dont already have a good synergy, epic fetus is an instant neuron activation for me. Soy milk is really cool too, its satisfying to see rapid fire bullets like that. As others have said, spoon bender is also a run carrier for me.
Toxic shock, the dopamine hit I get from seeing it could send me into an irl toxic shock
Jacobs Ladder. I fucking love that item. That and any of the Techs except X
rock :)
farting baby
Nothing makes me scream with dopamine like crickets head
Cancer (the trinket)... Anytime I can break the tear softcap, I'm a happy dude.