Sorry if this has been discussed already (or debunked), but I am new here and had a theory I wanted to share and see what you all think. This seemed like the right post
Oathbringer showed us that a perfect gemstone can trap one of the unmade. Now we know that Hoid has a topaz and that it was completely worthless for Hoid wearing it.
What if Andolsium’s essence or mind is trapped in the first gem and Hoid was getting knowledge either by directly talking to Andolsium or by absorbing his knowledge indirectly? It makes sense that this would kill the body whereby shards could be created and split amongst the original vessels. When Hoid wore the first gem he took as much knowledge as he could from Andolsium and that’s why he’s out to save the world. He has a connection to Andolsium and wants to negate the destruction that Odium or one of Andolsium’s other shards wreaks upon the cosmere.