1 Health as Hit Points

In TBoI, just like in many other games, there are Health Points/Hit Points, representing the player’s general health and ability to continue on—a remnant from roleplaying games. TBoI borrows many design elements from The Legend of Zelda, health being only one of those: Isaac starts3 with three hearts and takes half a heart of damage per hit taken. When there are no more hearts, the game is over.

So far, so good. Normal videogame health. However, special mechanics start right here. In particular, a good TBoI player should know how health works in TBoI and, much more importantly, how to use health effectively.

Special Case 1: Bosses, champions and the second half of the game
Almost all Bosses’ attacks deal one full heart of damage. There are also champion enemies, which are “amped-up” versions of regular enemies in one way or another (extra health, extra attacks, explosive death, etc.) Champion enemies also deal 1 full heart of damage per attack
Also, from floor 7 (Womb 1) onwards4, all regular attacks deal one full heart of damage.

There are also other ways of getting damaged that are not enemies:

Special Case 2: Environmental damage
The main sources of environmental damage are spikes on the floor and fireplaces of different colors. Stepping on either of these will result in a full heart of damage

It’s worth noting that, just like in TLoZ, your maximum HP is determined by how many Heart containers you have. Once you’ve reached this maximum, you cannot pick up additional hearts unless they are empty (that is, after you’ve taken damage. In general, you can gain extra heart containers by obtaining an “HP-up” pickup item like the following

Magic Mushroom <3 Raw Liver (+2 HP)
Lunch Dinner 5 Dessert 6
Breakfast Rotten Meat Super Bandage
The Halo Blood Bag Odd Mushroom (thick/fat version)
Bucket of Lard (+2 HP) Stigmata Stem Cells
Sacred Heart Holy Grail Super Meat Boy Super Fan
Meat! Placenta Old Bandage (only gives you an empty heart container)
Black Lotus Magic Scab Capricorn
Maggy’s Bow Thunder Thighs The Body (+3 HP)
Blue Cap Crack Jacks Moldy Bread

Several of these also come with one or more additional changes, but for the purposes of this guide I will not list them all. See the references for more information.

(None) ← Health in The Binding of Isaac2: Other Sources of health

  1. Combined in its original Flash format and the re-release The Binding of Isaac Afterbirth+↩︎

  2. Well, not generally↩︎

  3. I will be using Isaac and not the other characters as a basis for comparison. The differences will become evident as the guide progresses↩︎

  4. Yes, beating Mom is barely the beginning of the real game.↩︎

  5. Actually a can of Dog food↩︎

  6. Actually a bag of Dog food↩︎

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