1st Optimal vs Strut Health
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: coaching bundled into the price rather than sold separately
Visit 1st Optimal →
Strut Health
Best for: semaglutide at $99/month, 48% under the register median
Visit Strut Health →Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Strut Health starts at $99/mo, and Strut Health finishes ahead, 8.5 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.
Strut Health
Auto Refill starting at $99, Save 21%; one-off price higher
Auto Refill starting at $149, Save 13%
Auto Refill starting at $199, Save 17%; one-off 30-day supply $239
Auto Refill starting at $199, Save 14%; page also shows 30 DAY SUPPLY $325 compare-at price
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
Strut Health
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
Strut Health
8.5/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Strut Health |
|---|---|---|
| Starting Price | — | $99/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | 49 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | ✓None | 1 warning |
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 Strut Health
Strut Health sells LegitScript and ACHC-accredited compounded semaglutide and tirzepatide in injectable and oral lozenge formats, shipping to 49 states. Board-certified US physicians handle prescribing and follow-up messaging is unlimited and free. Eligibility is gated behind a clinician determination of medical necessity that the company does not publicly define.
Read our full Strut Health 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
Strut Health
What we like
- Semaglutide at $99 a month, 48% below the $189 median for the same drug and form across this register
- 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
- Coverage is published for 49 states
Watch-outs
- No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
- 1 FDA warning letter matched to this operator in our enforcement register — read what the letter alleges, since a letter discloses a problem rather than disqualifying a seller
- 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
Strut Health takes it, 8.5 against 3.9, and it is especially strong on semaglutide at $99/month, 48% under the register median. 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 Strut Health if…
You want semaglutide at $99/month, 48% under the register median and an opening price near $99 a month.
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Gala
Moving between compounded and brand without changing seller
From $129/mo
Get started →Trimi Health
Knowing which pharmacy fills the vial — it names VialsRx
From $99/mo
Get started →Strut Health
Semaglutide at $99/month, 48% under the register median
From $99/mo
Get started →1st Optimal vs Strut Health: FAQ
Glossary
The words sellers use, defined. Tap any term.
- Semaglutide · Drugs and brands
- Tirzepatide · Drugs and brands
- Compounded GLP-1 · Pharmacy and drug forms
- 503A pharmacy · Pharmacy and drug forms
- PCAB accreditation · Pharmacy and drug forms
- Prior authorization (PA) · Insurance and regulatory
- Off-label use · Insurance and regulatory
- FDA Drug Shortage List · Insurance and regulatory
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