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Survival mode
No Perks
No Purchases
No Crafting
No Cooking
No Workshop
No Power Armor
No VATS
No Fast Travel
No Quick Save
and No Companions.
https://www.youtube.com/watch?v=u_aS6xpd1qo&list=PLWfn8XPMjoaNBJ-IswWdQKOMkGDeXDaIu&index=1
Even without Perks and stuff under a no level cap system, eventually, you reach God Hood.
In normal play on highest non survival sifficuly this starts to be the case at around level 20-25.
Eventually. But in that video he's taking on Kellogg and later a Red Skull Deathclaw using only the weapons and armor he can find, with no perks to increase his damage or resistances at LvL 15.
And imagine Survival mode using only the antibiotics you can find and no doctors.
Just killing the Deathclaw at lvl 2 without using the Power Armor is not an easy task.
That's pretty hardcore.