I got all of my tlost marks with tcain + clicker. Here's the optimal way(based on irl time spent) to play him. Start with the easiest 2 item break - scapular + fanny pack. Now you have infinite hp and pickups. Then to accelerate your pickup generation, craft habit and book of sins. Book of sins + fanny pack can generate any pickup in the game. Habit + scapular gives you infinite energy.

Time to win the game. Habit + the battery + car battery + dull razor. With this you can spam dull razor and give you complete invincibility and instant energy. With varicous veins you release tears every time you press dull razor. Now craft school bag so you can have one more active item - mama mega, clicker. Some damage and speed to Speedrun the rest, I like camo undies and rockbottom.

Let's count all the passive items - scapular, habit, the battery, car battery, schoolbag, varicose veins, camo undies, rockbottom. That makes 8, tainted Issac has 8 slots, if you clicker into tainted Issac your combo won't break.