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1st Optimal vs iThriveMD

An in-depth comparison of two leading GLP-1 Providers

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By Ruth Calder · Enforcement Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed
1st Optimal logo

1st Optimal

3.9
★★☆☆☆2/5

Best for: coaching bundled into the price rather than sold separately

Visit 1st Optimal
VS
iThriveMD logo

iThriveMD

6.6
★★★☆☆3.3/5

Best for: seeing what it charges before you answer any medical questions

Visit iThriveMD

Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, iThriveMD starts at $299/mo, and iThriveMD finishes ahead, 6.6 to 3.9. What follows: the prices, what each plan actually covers, the six-dimension score, where each one is weak, and who should pick which.

Pricing

1st Optimal

Pricing not publicly listed.

iThriveMD

Starting (preferred pricing lower)Compounded
$299/mo
semaglutide
Starting (preferred pricing lower)Compounded
$399/mo
tirzepatide

What’s included

1st Optimal

Covered by the monthly price

Medication

Not stated

Clinician visits

In the price

Shipping

In the price

Lab work

Not stated

Coaching

In the price

iThriveMD

Covered by the monthly price

Medication

In the price

Clinician visits

In the price

Shipping

In the price

Lab work

Not stated

Coaching

Not stated

Score breakdown

Both providers are scored on the same six-dimension framework. The gradient bar marks the stronger side on each dimension.

1st Optimal

3.9/10

Overall

iThriveMD

6.6/10

Value25%

3.0A
vs
B
3.0

Effectiveness25%

5.0A
vs
B
10.0

User Experience15%

2.0A
vs
B
7.5

Trust & Safety15%

4.0A
vs
B
6.5

Accessibility10%

5.0A
vs
B
5.0

Support10%

5.0A
vs
B
7.0

Features & Coverage

Feature1st OptimaliThriveMD
Starting Price$299/mo
Features8 features8 features
States AvailableNot disclosedNot disclosed
Compounded✓ Yes
Brand Name
FSA/HSA Accepted
FDA WarningsNoneNone

About 1st Optimal

Neither a monthly price nor a list of states is published. 1st Optimal operates out of Michigan across telehealth and functional medicine, writing the GLP-1s semaglutide and tirzepatide either as a weekly injection or as a daily oral tablet. Around the prescription it stacks at-home lab testing, interpretation of the blood work, coaching without limit and protocols built individually, all framed as long-term weight loss and longevity. Credentialed providers work virtually, treatment goes to the home, and nothing binds you to a long contract.

Read our full 1st Optimal review →

About iThriveMD

Compounded GLP-1 semaglutide opens at $299/mo and tirzepatide at $399/mo, with microdosing tirzepatide programs beside them and cheaper 'preferred pricing' held back for members. The initial consultation is free and protocols are built off labs. iThriveMD keeps physical locations as well as telehealth, and works metabolic health next to diagnostic lab testing, IV therapy, peptides, NAD+, sexual health and hormone therapy (HRT/TRT). Its legal and policy documentation is thorough. Nobody names the compounder and no LegitScript certification appears.

Read our full iThriveMD review →

Pros & Cons

1st Optimal

What we like

  • The monthly figure covers consult, shipping, coaching
  • No FDA warning letter matched this operator when we searched our enforcement register
  • A live video visit with a clinician is required before a prescription, which is slower than a form and is the more careful intake
  • Baseline bloodwork is required before a prescription

Watch-outs

  • No price appears until the medical intake is complete, so the cost cannot be compared before health information is submitted
  • No state list is on record here, so whether it serves your state cannot be confirmed from this page
  • No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here

iThriveMD

What we like

  • Publishes a price on its own site before the medical questionnaire, so it can be compared without handing over health information
  • The monthly figure covers medication, consult, shipping
  • No FDA warning letter matched this operator when we searched our enforcement register
  • Baseline bloodwork is required before a prescription

Watch-outs

  • No state list is on record here, so whether it serves your state cannot be confirmed from this page
  • No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
  • Its semaglutide and tirzepatide are compounded rather than FDA-approved, so they have not been reviewed by the agency for safety, effectiveness or manufacturing quality

Our Verdict

Winner: iThriveMD

iThriveMD takes it, 6.6 against 3.9, and it is especially strong on seeing what it charges before you answer any medical questions. 1st Optimal is no weak second and may fit you better on coaching bundled into the price rather than sold separately.

Choose 1st Optimal if…

You want coaching bundled into the price rather than sold separately.

Choose iThriveMD if…

You want seeing what it charges before you answer any medical questions and an opening price near $299 a month.

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7.9

Oak

Semaglutide at $119/month, 37% under the register median

8.8

Found

Tirzepatide at $169/month, 37% under the register median

8.3

Telos Rx

Starting below a standard dose, with microdose tiers

1st Optimal vs iThriveMD: FAQ

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