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Izanami thrives at lower health because of her passive, thus making items like the Asi preferable in my opinion over some other life steal items. Qin's Sai are the end all tank shredder for Izanami since she is primarily auto-based. I would recommend purification beads to mitigate any stuns it slows. It is worth noting that her 3 is her escape, but can be canceled with heavy CC.
Hunter's Cowl
Ninja Tabi
Asi
Deathbringer
Qin's Sais
The Executioner
Purification Beads
Substituting some of Izanami's physical resistance shred, the shadow shuriken works well for anti-heal, either for life-steal heavy gods or heal gods. In a team fight, she is able to mitigate multiple targets healing with her abilities, as well as her auto's before using her 1.
Hunter's Cowl
Ninja Tabi
Asi
Qin's Sais
Shadowsteel Shuriken
Deathbringer
Purification Beads
Y
B
A
X
Tap each threat level to view Izanami’s threats
Izanami's passive makes her a ver niche ADC in that she does more, the more health she has missing. This makes items like the Asi good for her since the increased life-steal on reaching 35% health lets her stay in a situation most ADC might want to avoid to get the kill.
Pen items can be a waste of gold on her as she also gains penetration from her passive.
Qin's Sai are really the power behind her auto though in my opinion. The additional health damage, again combined with her natural pen makes her a tank killer.
Abilities
1. Gives greater attack speed and power.
2. Slows enemies and does a decent bit of damage to boot
3. Escape or gap close, makes her versatile and hard to kill. (Can be canceled with CC)
4. Silences in an AOE and does decent damage.
Passive: The closer she is to death, the more damage she does, up to 20% for each 10% of her missing health. Her basic attacks increase in projectile speed with higher attack speed and only trigger items on first target hit per attack. (Though life-steal seems to prock through all hit targets from my observation).
Main build:
Cowl
Gives some early sustain as well as base life-steal you'll use throughout the game. Good starter item with perks for duo laning in Conquest, or team fighting in Assault, Joust, etc.
Asi + boots
Attack speed is not only great for ADC in general, it also makes her attacks move faster in the air. Attack speed boots are my first go-to for early game attack speed, followed by Asi for the health sustain.
Since her passive allows her to do more damage and pen at lower health, Asi also allows you to stay that extra few minutes since it gives an additional 35% life-steal at low health. As Izanami, your goal is to kill it fast, so be careful how long you stay, the buff only lasts so long.
DeathBringer
A lot of builds I've seen like to use Rage for a crit item, I disagree with this choice. Death bringer is able to do 30% additional damage with a 25% crit chance, as fast as you attack with Izanami, you'll be critting fine and HARD with Deathbringer as your item.
Qin's Sai
In my opinion, this is your bread and butter. No matter what you're hitting, you're doing 3% health, faster and harder. Health tanks start to look like tasty targets instead of frustrating walls of damage mitigation, just watch out for CC. On squishier targets, this combined with the crit from Deathbringer really just demo's anything that can't either out damage you or stun you.
Executioner
Great for power and that last bit of attack speed, plus it helps to remove any physical resistances from the enemy bruisers or tanks again making you an enemy shredder.
Shadow Shuriken
Gives attack speed and power while disabling healing effects or life-steal by 40%. Not a bad choice against another ADC that only wins out because their life-steal + Power is to much for you. Works well with an auto champion since it will simply re-apply as fast as you hit them instead of them getting away and healing outright.
Purification beads
MUST HAVE for Izanami. Her biggest downfall is CC. Her escape does not make her immune and you can be stunned while in the middle of it. If a heavy CC comp starts to dump on you, pop beads AND THEN 3 out or you might just be screwed.
While I have Hunters Cowl mentioned, either cowl should be used depending on the situation and how you feel about it. One works better with a good team around you, the other would help in a disadvantaged situation.
LATE LATE game if you're rolling in gold and have the ability, ditch your boots for a swiftness potion, grab a power potion, and see what other items might fit your personal taste for the character. Adding in whatever is missing from one of the two builds I've listed doesn't work badly either.
IMPORTANT TIPS:
Izanami's 1, while active, prevents her from attacking through multiple targets. It is best NOT to use this until you're clear to hit the enemy god only. Using this in a bunch of minions will mitigate your healing and probably prevent you from securing the kill if that ONE wisecrack minion decides to face tank for their team.
Izanami's 2 slows but also does a lot of damage. Use it to engage or disengage as you see fit. Can also be used to slow enemies before retreating, or helping a low teammate get out alive.
Izanami's 3, while making her relatively invisible, does not make her invulnerable, keep this in mind.
Izanami's 4 has a slight delay but silences everything in a team fight. This works really well to help you fight off ability-based enemies and can be used to start, end, or disrupt a fight as needed.
Good luck and happy hunting.
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I expect people who really play the god a lot to be able to interchange their own items as they feel like it. My intention with the guide here was to help new people find items and reasons to help learn with.
I use sites like this to help me learn, and then seldom refer back to them later once I understand the game my self.
on the topic of only
meanwhile,
and it is cheaper
The whole requirement for crit is that you need to reach a reliable amount of % crit to have your autos crit reliably with 60-75% being considered a minimum point (which is usually reached
Makes it more reliable in the event of nerfs and item changes. I agree rage is cheaper, but I don't plan on building 2ndary crit items in this build. I instead make the build shred health in other ways and rely on Izanami's pure attack speed to compensate.
If you don't plan on having the build be reliant on crit, then the BEST think you can do is in fact to go with the most reliable boost of DPS, which as Devampi was stating above, is likely to be
- Any build you present should probably be the best for the current time. Why would you not want to optimize it for use right now?
Deathbringer is a somewhat expensive item in that mid-game slot. 
Rage makes more sense right there, and is in fact commonly build around that slot. (Alternative thought, 500 gold isn't all THAT much, and DB in fact will provide a very similar average DPS as a single crit item)
- Not so sure you need
Asi there. Yes, if you're planning to box a lot, the lifesteal of 
Leather Cowl and 
Asi is going to be quite nice, but you're not at a build stage where you're going to have a boxing advantage over many other hunters. I don't think it's necessary or optimal there. There's a reason, power-spike-wise, that higher power items such as Devo's are often chosen after completing Tabi.
- If in fact you do want
Deathbringer as your only crit item, your better option to make that crit more reliable (and thus more worth investing into) would be to plan a bit further ahead and get 
Gilded Arrow to upgrade into 
Ornate Arrow. Sure, you'll be missing out on the early lifesteal, but that's why you could probably start looking more into 
Devourer's Gauntlet over Asi. But that's your choice.
What I'm getting at is...I don't think this build is optimal for the concept you're trying to drive. Let me provide you with some stats and other thoughts, as I'm not sure you've checked everything.You say you feel she thrives at lower health, but you're squishy and I don't think you should be trying to optimize her function only when at lower health. You want her to be as effective as possible at all levels of health.
- Before replacing
Ninja Tabi, your build with 
Hunter's Cowl (and assuming a teammate is nearby) is already maxed at 2.5 AS...that's WITHOUT her steroid. I'm guessing you didn't realize that...that's quite inefficient use of her kit. Thus, you have more AS than you need, and 
Sickle Storm is then only good for the slight bonus damage and the change to single hit (rather than requiring hitting up and back for full damage). You can stand to lose some AS somewhere. Where would that be? 
Asi.
Sickle Strike. Switch 
Asi out for 
Devourer's Gauntlet in the same location, and you get more reliable lifesteal at all levels of health. Your DPS without steroid drops against that squishy a bit, to 735, but with steroid gets a bit higher to 778.
- If we go further and play around with switching out
Hunter's Cowl instead for 
Ornate Arrow and assume you have the appropriate amount of gold in hand to have max stacks, your DPS in fact will be even higher. Taking the following build example into account (Ornate, Ninja, DEVO'S, DB, Qin's, Exe), your DPS with Arrow instead of Cowl is 794 without steroid (2.173 AS), and 913 with steroid activated. Immediately it's got a significant boost to your average DPS by getting Ornate and Devo's instead of Cowl and Asi. Yes, you lose out on some lifesteal potential at lower health, but the consistently higher DPS is worth it IMO.
- However, if we have you commit to a true crit build over a crit + Qin's build, switching out
Qin's Sais for 
Rage (and getting Rage early w/ DB in the Qin's spot for better item purchase order), your DPS jumps significantly to 1,066 against those squishy targets. It will even beat out Qin's against a 3,000 health target by about 20 DPS average.
In the end, if you're looking at max DPS, I think your best build direction with build order considered for best efficiency is to go eitherAs an FYI, against a squishy level 20 enemy with 70 inherent physical protections and 2,000 health, your DPS is 757. *Note* all DPS values I provide will not include the bonus damage of 25 from
Finally, you really should throw in your suggestion of late-game Tabi replacement. I don't see that anywhere.