Is it possible to save the twitch settings? If I wanted to stream from two accounts, I would have to change twitch options every time.

No, there is no way to do this and I cannot promise this will get added as it would be very low priority

Understand. Its a really niche problem.

You could always use   https://sandboxie-plus.com/sandboxie/      

You can isolate data from program and different boxes, I use it for browsers and games that support it basically you can have finite versions of a save  files