Tonsil
ItemAfterbirth+Unlocked
familiarGame ID 474
How do you unlock Tonsil?
Verified starting unlockSource data confirms that no unlock is required.
Grants a familiar that follows Isaac and blocks enemy shots.
Available from the start
No unlock needed — this is available in every new save file.
What unlocking Tonsil leads to
Nothing depends on this yet.
Source: bindingofisaacrebirth.wiki.gg
Imported 2026-09-13