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@Sabres297 That's the point, similarly to Horror Babylon, it is usually a good idea to at least fill yourself up with soul/black hearts, while ridding yourself of red hearts to basically permanently apply the effect. In this case, it's just not necessary to rid yourself of red hearts and instead just need to protect them.
@zomby2511 Actually, we have no way to track when Isaac specifically picks up a collectible, so we can't "cancel" the pickup if the player already has brimstone.