Tonsil

Tonsil is a trinket added in Afterbirth †.

Effects

• When hit, there is a small chance a removed tonsil familiar starts following Isaac, blocking enemy shots.
  • The effect can happen twice, after which the trinket will be destroyed.
  • The familiar does not deal damage to enemies.

Notes

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• When the familiar is generated, Isaac will gain the familiar permanently as a passive item. This allows Isaac to drop the trinket while keeping the familiar.
  • The passive Tonsil item does not exist in any item pool; thus, this is the only way to find it and make it appear in the Collection Page aside from starting with it as Eden.
• If Eden starts with the passive tonsil item and picks up the trinket, the trinket will spawn only one familiar before being consumed.
• On average, each familiar spawns after 16 hits.
• Sources of self-inflicted damage, like IV BagUpon activation, Isaac loses a half-heart (one whole heart in The Womb onwards) for a random amount of coins, similar to the blood donation machine. or Blood Donation Machines, can spawn a familiar.

Trivia

• Tonsils are soft tissue located near the back of the throat which can be removed without much noticeable difference.