diff --git a/soh/soh/Enhancements/mods.cpp b/soh/soh/Enhancements/mods.cpp
index 7ad8473f1..24077697f 100644
--- a/soh/soh/Enhancements/mods.cpp
+++ b/soh/soh/Enhancements/mods.cpp
@@ -400,6 +400,52 @@ void RegisterShadowTag() {
     });
 }
 
+static bool hasAffectedHealth = false;
+void UpdatePermanentHeartLossState() {
+    if (!GameInteractor::IsSaveLoaded()) return;
+
+    if (!CVarGetInteger("gPermanentHeartLoss", 0) && hasAffectedHealth) {
+        uint8_t heartContainers = gSaveContext.sohStats.heartContainers; // each worth 16 health
+        uint8_t heartPieces = gSaveContext.sohStats.heartPieces; // each worth 4 health, but only in groups of 4
+        uint8_t startingHealth = 16 * 3;
+
+
+        uint8_t newCapacity = startingHealth + (heartContainers * 16) + ((heartPieces - (heartPieces % 4)) * 4);
+        gSaveContext.healthCapacity = MAX(newCapacity, gSaveContext.healthCapacity);
+        gSaveContext.health = MIN(gSaveContext.health, gSaveContext.healthCapacity);
+        hasAffectedHealth = false;
+    }
+}
+
+void RegisterPermanentHeartLoss() {
+    GameInteractor::Instance->RegisterGameHook<GameInteractor::OnLoadGame>([](int16_t fileNum) {
+        hasAffectedHealth = false;
+        UpdatePermanentHeartLossState();
+    });
+
+    GameInteractor::Instance->RegisterGameHook<GameInteractor::OnPlayerUpdate>([]() {
+        if (!CVarGetInteger("gPermanentHeartLoss", 0) || !GameInteractor::IsSaveLoaded()) return;
+
+        if (gSaveContext.healthCapacity > 16 && gSaveContext.healthCapacity - gSaveContext.health >= 16) {
+            gSaveContext.healthCapacity -= 16;
+            gSaveContext.health = MIN(gSaveContext.health, gSaveContext.healthCapacity);
+            hasAffectedHealth = true;
+        }
+    });
+};
+
+void RegisterDeleteFileOnDeath() {
+    GameInteractor::Instance->RegisterGameHook<GameInteractor::OnGameFrameUpdate>([]() {
+        if (!CVarGetInteger("gDeleteFileOnDeath", 0) || !GameInteractor::IsSaveLoaded() || &gPlayState->gameOverCtx == NULL || &gPlayState->pauseCtx == NULL) return;
+
+        if (gPlayState->gameOverCtx.state == GAMEOVER_DEATH_MENU && gPlayState->pauseCtx.state == 9) {
+            SaveManager::Instance->DeleteZeldaFile(gSaveContext.fileNum);
+            hasAffectedHealth = false;
+            std::reinterpret_pointer_cast<LUS::ConsoleWindow>(LUS::Context::GetInstance()->GetWindow()->GetGui()->GetGuiWindow("Console"))->Dispatch("reset");
+        }
+    });
+}
+
 struct DayTimeGoldSkulltulas {
     uint16_t scene;
     uint16_t room;
@@ -1088,6 +1134,8 @@ void InitMods() {
     RegisterDaytimeGoldSkultullas();
     RegisterRupeeDash();
     RegisterShadowTag();
+    RegisterPermanentHeartLoss();
+    RegisterDeleteFileOnDeath();
     RegisterHyperBosses();
     RegisterHyperEnemies();
     RegisterBonkDamage();
diff --git a/soh/soh/Enhancements/mods.h b/soh/soh/Enhancements/mods.h
index 2f0430475..8125659ab 100644
--- a/soh/soh/Enhancements/mods.h
+++ b/soh/soh/Enhancements/mods.h
@@ -9,6 +9,7 @@ extern "C" {
 
 void UpdateDirtPathFixState(int32_t sceneNum);
 void UpdateMirrorModeState(int32_t sceneNum);
+void UpdatePermanentHeartLossState();
 void InitMods();
 
 #ifdef __cplusplus
diff --git a/soh/soh/SohMenuBar.cpp b/soh/soh/SohMenuBar.cpp
index 614a6b690..9a006fb86 100644
--- a/soh/soh/SohMenuBar.cpp
+++ b/soh/soh/SohMenuBar.cpp
@@ -660,6 +660,14 @@ void DrawEnhancementsMenu() {
 
             if (ImGui::BeginMenu("Difficulty Options"))
             {
+                UIWidgets::PaddedEnhancementCheckbox("Delete File On Death", "gDeleteFileOnDeath", true, false);
+                ImGui::PushStyleColor(ImGuiCol_Text, ImVec4(1.0f, 0.0f, 0.0f, 1.0f));
+                UIWidgets::Tooltip("Dying will delete your file\n\n     " ICON_FA_EXCLAMATION_TRIANGLE " WARNING " ICON_FA_EXCLAMATION_TRIANGLE "\nTHIS IS NOT REVERSABLE\nUSE AT YOUR OWN RISK!");
+                ImGui::PopStyleColor();
+                if (UIWidgets::PaddedEnhancementCheckbox("Permanent heart loss", "gPermanentHeartLoss", true, false)) {
+                    UpdatePermanentHeartLossState();
+                }
+                UIWidgets::Tooltip("When you lose 4 quarters of a heart you will permanently lose that heart container.\n\nDisabling this after the fact will restore your heart containers.");
                 ImGui::Text("Damage Multiplier");
                 UIWidgets::EnhancementCombobox("gDamageMul", allPowers, 0);
                 UIWidgets::Tooltip(