Depends on genre of the game. In a (good) survival horror title or something like Metro 2033 it is heavily encouraged you pick up absolutely everything you can, and I will. In an RPG I am usually just fine ignoring optional superbosses and ridiculous equipment and so on. I also dont hoard my healing supplies and end the game with 80-something mega potions. Godammit, they're there to be used.

I remember discovering I had lost access to the Zodiac Spear in FFXII, and it didn't bother me one smurfing iota. I beat the game and turned a blind eye to the more ridiculous hunts and rare monsters. I guess when it comes down to it I really just play roleplaying games for the story more than attempting to become the supreme master of the universe. Character progression is fun to a point, but it gets to a point where I say its not worth it. Thats what turned me off of World of Warcraft very quickly. Its probably why my favourite RPG titles are stuff like Dragon Age and Suikoden