In Elden Ring players are offered one of nine keepsakes to choose from the character creation screen. Most FromSoftware games have keepsakes like this, sometimes called starting gifts, and Elden Ring brings back some fan-favorites alongside a handful of totally new options.
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Some of these keepsakes in Elden Ring are way more useful than others in the long term, so think carefully when choosing one. The Cracked Pot, for example, can be bought for a paltry sum of Runes from the first merchant in the game. On the other hand, the Golden Seed permanently increases your Flask uses and is beneficial throughout the entire game.
The Crimson Amber Medallion works much like the Life Ring from the Souls series. It's a Talisman players can choose from the start that increases Maximum HP by a small amount. It's a good choice for beginners who want a little extra wiggle room when taking damage.
The HP increase is small but equivalent to a handful of levels put into the Vigor stat. It's not the most broken starting item, but it's far from the most useless, and serves as a good option if nothing else calls to you.
The Lands Between Rune is a consumable item that is far more useful when first starting out than later on. By using this item, the player will gain 3000 Runes instantly. After a few levels, this doesn't seem like a lot, but if you use it immediately upon entering the world you can get a good 3-4 levels out of it (depending on your starting class level, that is).
The Lands Between Rune, and other consumable Runes like it, work just like consumable Souls from the Dark Souls series. Unlike Runes that have been collected, these consumables aren't lost on Death. Therefore, they are best used when next to
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