Advanced Permanent Serum Guide

In this guide I will show you the most efficient way to consume permanent serums

Prologue

The new game plus DLC is just around the corner. To get you started as efficiently as possible, I'll explain how you should and shouldn't use the permanent serums in your first run.
For this guide you need the Way of The Hunter and Ravenwood Stories DLC.

Refinfined and Purified Serum Crafting

All the basic information about how to make a serum you can find in this Guide, it's perfect, big thanks to Tamaster.

To efficiently craft Refined Serums you only need 100 Survival points in the Skill Crafting, but it is best to allocate 120 points to craft two at once.
(It's the best Survival skill anyway in my opinion)
Thanks to this skill, you don't need any Superior or Premium ingredients for the Permanent serum to reach the Refinfined quality level.

However, if you want to make a Purified Serum, all ingredients must be of Premium quality without exception. However, the required pre-stage serum may and should be a Refined Serum.

Convert all Serums to Purified quality

There is a way you can convert any Normal or Refined grade Serum into Purified Quality.
To do this, you need to complete the Cooking Quest and receive an item after you reach the Master Cook Rank. So if you want to get the most out of it, complete the quest first before you start consuming serums.

Mitigate Diminishing returns

Diminishing returns are very high in this game. Fortunately, this can be mitigated somewhat with the Intolerance Skill wich needs another 120 points in the Survival Skill Medicine.

So the first thing you need to do is distribute 120 points in Crafing to lower the cost of crafting Refined Serums, and then distribute another 120 points in Medicine so you can consume your crafted Serums without having high diminishing returns.

But how is this possible to have 240 Survival Points without grinding too much you may ask.

Dimishing Return Calculation: x * (y^n)
Is the value that is being added every time you use an Serum after the first Serum use.

Vitality increase Example:

x = 16 (Purified Serum HR3)
y = Diminishing returns, wich is 15% without Intolerance and 5% with Intolerance
n = Consumption counter after the first Serum use

PS: Dimishing Return Calculation as the Field Nurse Class is: x * 1,25 * (y^n)

Grinding 240 Survival Points

Start a new game with the Occupation: Game Developer. Normal or Hardmode doesn't matter for this procedure.
Only as a game developer you get 8 skill points per level, all other Occupations get only 5 points. Additionally you can distribute 25 points freely right from the Start.

So with Survival Level 27 you would have a total of 241 points to distribute. However, since you can actively gain 7 points in medicine simply by using items such as Bandages, Vodka, Potassium Iodide Pills, or Serums, level 26 is enough.
Just don't use any permanent Serum before achieving 120 Points in Medicine.

But what is the fastest way to get Survival points apart from quests and strangle NPCs?
After you reach 120 points in crafting, you can directly start making Permanent Serum and of course other serums that you can use.
It is best to buy the fishing huts in Ravenwood, any kind of storage that is available and of course the farmland.
Harvesting the seeds gives a lot of XP, for making the Permanent Serums you will have to grow and harvest a lot anyway.

However, you will find that this is probably not enough to reach Survival 26. Therefore, my personal grind recommendation:
Grow potatoes, fry and eat them, chop wood and start again with growing. For all of it you get XP

Is the Grind really worth it?

Decide for yourself, here are the test results with and without 120 Points in Medicine.

My Base Vitality = 100:
20x Refinfined Serum HR3 without Intolerance 176,9 Vitality
40x Refinfined Serum HR3 without Intolerance 179,9 Vitality
60x Refinfined Serum HR3 without Intolerance 180,9 Vitality
20x Refinfined Serum HR3 with Intolerance 254,0 Vitality
40x Refinfined Serum HR3 with Intolerance 309,2 Vitality
60x Refinfined Serum HR3 with Intolerance 328,9 Vitality


My Base Stamina = 120
20x Refined Serum SR2 without Intolerance 312,2 Stamina
40x Refined Serum SR2 without Intolerance 319,7 Stamina
60x Refined Serum SR2 without Intolerance 320,0 Stamina
20x Refined Serum SR2 with Intolerance 504,9 Stamina
40x Refined Serum SR2 with Intolerance 642,9 Stamina
60x Refined Serum SR2 with Intolerance 692,4 Stamina


My Base Arm Strenght 110%
20x Refinfined Serum AS2 without Intolerance 398,4% Strenght
40x Refinfined Serum AS2 without Intolerance 409,5% Strenght
60x Refinfined Serum AS2 without Intolerance 410,0% Strenght
20x Refinfined Serum AS2 with Intolerance 687,4% Strenght
40x Refinfined Serum AS2 with Intolerance 894,3% Strenght
60x Refinfined Serum AS2 with Intolerance 968,5% Strenght


My Base Carry weight 58,0 Kg
20x Refinfined Serum CW3 without Intolerance 106,1 Kg
40x Refinfined Serum CW3 without Intolerance 107,9 Kg
60x Refinfined Serum CW3 without Intolerance 108,0 Kg
20x Refinfined Serum CW3 with Intolerance 154,2 Kg
40x Refinfined Serum CW3 with Intolerance 188,7 Kg
60x Refinfined Serum CW3 with Intolerance 201,1 Kg

My Purified Serum end results.
60x Purified Serum HR3 with Intolerance 405,3 Vitality
60x Purified Serum SR2 with Intolerance 883,1 Stamina
60x Purified Serum AS2 with Intolerance 1254,7% Strenght
60x Purified Serum CW3 with Intolerance 248,8 Kg

[Arkos]

Nice to know that Medic occupation gives bonus here too. And it's really big bonus.
Also there's very simple way to skyrocket grind survival level with crafting.
Not sure if I should exposure it here, since it more feels like exploit and ruins game experience with a lot of clicking w/o gameplay at all.

[Gutseberek]

Golden spoon is OK for normal serums but when crafting perma serum, it's best to use premium ingredients in order to have an "enhanced permanent effect". Meaning you're receive double effect of the perma serum.

[bercerus]

is this guide still accurate in 2024? any change?

[Myzze]

If you have the golden spoon, is there any reason to use premium ingredients at all?

[into sunset]

I run a test,as nurse,the results are 18-22%more efficiency with same condition.
60 serum hr3 increase vitality to 481 which can be useful in ng+.

[Wafflcopterz]

Where do you find the "Occupation: Game Developer" for new game start? I don't see it in the list of previous occupations, and the current occupation is locked to "Journalist" because of the story.

[Cyborgt]

Do you think it would be worth it to put 20 points in foraging at the start of the game? I'm not sure how much the bonus harvesting from foraging actually does but I have noticed that how much xp you get for picking a wild plant seems to depend on how many of the serum usable item you harvest from it. As such, if the first foraging skill has a meaningful impact on harvest rates, I would think that would likely make up for the 20 point loss with xp gain during the grind.

[jei]

Why did mine stop at 206 vitality? Only used below 20 purified serums for vitality

[Sithicus]

I've taken this a step further and I've used serums until they had no effect and my end results:

Vitality - 429.6
Stamina - 899.9
Lift capacity - 299.9
Arm strength - 1322.9%

[Megan]

Purified, you should never use refined, that just lowers your soft cap. I didn't put any points in Crafting; it's unnecessary when you have the Golden Spoon. I maxed out Crafting anyway just by cooking.