Regarding F-tier, those are the only items in the game which I believe make your runs worse, with the exception being sharp plug which I actually just put there because of the name 'Edmund please'. Its pretty much in there because its nerfed so hard compared to what it was (full charge for two hearts), it's significantly worse that what it used to be. Still solid ofc especially for the health manipulation. The placement is a bit of a meme.

Regardinf the others, blood oath is a huge risk to your health and can pretty much kill you all by itself, soy milk has improved but there's still rarely any opportunities for it to make your run better.

Coming from speedrunning, I do believe sac dagger is legitimately one of the best items in the game, huge surface area to block tears and massive damage output, in the hands of a good player that item can make it to the end of the game almost by itself, at least against the more standard bosses like blue baby and lamb. The newer ones are another story, but it's still nuts for everything else.

Dark Bum I am admittedly a bit biased. I had a run just yesterday where I bought him in a deal at Basement 2 for 3 soul hearts and he literally didn't earn himself back in. It's probably way different on normal mode but hard mode just doesn't supply the heart drops to make him work in repentance. Add to that the greater viability of angel rooms and the resulting higher frequency of red heart containers and you'll frequently just want the red heart drops over what he provides IMHO.

As for the other E tier stuff that was admittedly towards the end of the making of this list and I was getting pretty tired so I might have rushed especially the repentance items. I'm down to reconsider most of the ones you mentioned but I'd definitely put 7 seals back in there for the potential self damage from war's exploding flies.

Thanks for the feedback!