Honestly the underwhelming Mark of Consumption puzzled me for a long time as an Upheaval item that only adds some Bleeding Damage and I could not find a use for it in an Upheaval build. There often are better or more appropriate choices for the Medal slot when building for Upheaval.
I just put together a Vitality/Bleeding Savagery/Upheaval Warder build and it got me thinking that this item could get some (meme) support for Vitality/Bleeding which Shaman definitely is begging for.
If possible, I would add the following:
- +106% Vitality Damage to match the Bleeding Damage
- 200 Vitality Damage to Upheaval (probably a good start)
- 100% Lightning Damage converted to Vitality Damage to Upheaval (with visual Upheaval change as well!) - this will prevent Physical Avenger+Gladiator’s Distinction builds from gaining extra punch that they don’t need…
Mind you, this is for a Dual Damage build that is clearly meme, but that’s my thing so it’s what I focus on… 
This addition is not game-breaking by any means, but it goes along with the theme of the item and adds some support for Vitality Upheaval in the game where there is none currently.
Thanks for reading and feel free to post your thoughts! 