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1st Optimal vs Alegro Health

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

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By Eli Marsden · Founding Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed
1st Optimal logo

1st Optimal

6.7
★★★☆☆3.4/5

Best for: Patients wanting GLP-1 therapy within a lab-driven functional-medicine program

Visit 1st Optimal
VS

Alegro Health

6.5
★★★☆☆3.3/5

Best for: beginners wanting a low-cost 8-week compounded semaglutide starter with b12

Visit Alegro Health

1st Optimal and Alegro Health are both GLP-1 Providers competing for the same patients, but they make different trade-offs on price, coverage, and what's included. In our scoring, Alegro Health starts at $199/mo, and 1st Optimal edges ahead overall (6.7 vs 6.5 out of 10). Below we break down pricing, what each plan covers, the six-dimension score, pros and cons, and exactly who should pick which.

Pricing

1st Optimal

Pricing not publicly listed.

Alegro Health

StarterCompounded
$199/mo
semaglutide

199 dollars total for the full 8-week starter with B12 (about two months), select states, no monthly fees

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What’s included

1st Optimal

Inclusions not disclosed.

Alegro Health

What the monthly price covers

Medication

Included

Provider visits

Included

Shipping

Included

Lab work

Not disclosed

Coaching

Not disclosed

Score breakdown

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

1st Optimal

6.7/10

Overall

Alegro Health

6.5/10

Value25%

6.5A
vs
B
7.0

Effectiveness25%

7.0A
vs
B
6.5

User Experience15%

6.5A
vs
B
6.5

Trust & Safety15%

6.5A
vs
B
6.0

Accessibility10%

6.5A
vs
B
6.0

Support10%

7.4A
vs
B
6.5

Features & Coverage

Feature1st OptimalAlegro Health
Starting Price$199/mo
Features8 features5 features
States AvailableNot disclosedNot disclosed
Compounded✓ Yes
Brand Name
FSA/HSA Accepted
FDA WarningsNoneNone

About 1st Optimal

1st Optimal is a Michigan-based telehealth and functional-medicine platform offering GLP-1 weight loss medications, including semaglutide and tirzepatide, as once-weekly injections or daily oral tablets. Its model pairs prescription GLP-1 therapy with at-home lab testing, blood-work interpretation, unlimited coaching, and personalized protocols framed around long-term weight loss and longevity. Care is delivered virtually by credentialed providers, and treatments ship to the home with no long-term contracts. The site does not publish monthly pricing or a state list.

Read our full 1st Optimal review →

About Alegro Health

Alegro Health is a HIPAA telehealth practice based in McKinney, Texas that offers a low-cost compounded semaglutide weight-loss starter. Its headline offer is a semaglutide 8-week starter with B12 for 199 dollars, available in select states, shipped directly with no monthly fees. Care is delivered online after selecting your state, with a patient portal for follow-up. Alegro currently advertises semaglutide only; tirzepatide is not listed. Compounded medications are not FDA-approved. Support is available by phone.

Read our full Alegro Health review →

Pros & Cons

1st Optimal

What we like

  • Offers both semaglutide and tirzepatide with injectable and oral formats
  • Functional-medicine approach with at-home labs and blood-work interpretation
  • Unlimited coaching and ongoing support included
  • No long-term contracts
  • Board-certified doctors and nurse practitioners referenced

Watch-outs

  • No public monthly pricing disclosed
  • No published state availability list
  • Compounded vs branded sourcing not clarified on site
  • Pricing only revealed after quiz or consultation

Alegro Health

What we like

  • Low-cost entry point: 199 dollars for a full 8-week semaglutide starter with B12
  • Direct shipping with no recurring monthly fees
  • Operates from a physical Texas medical practice with a published phone number

Watch-outs

  • Semaglutide only; no tirzepatide offered
  • Available in select states only, which are not enumerated
  • Thin public information and compounding pharmacy not named on the site

Our Verdict

Winner: 1st Optimal

1st Optimal edges out Alegro Health with a higher overall score of 6.7/10 and is particularly strong for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program. Alegro Health remains a solid alternative, especially if you're looking for beginners wanting a low-cost 8-week compounded semaglutide starter with b12.

Choose 1st Optimal if…

You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

Choose Alegro Health if…

You want beginners wanting a low-cost 8-week compounded semaglutide starter with b12 and a starting price around $199/mo.

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7.3

Sunlight

Compounded GLP-1 with unlimited telehealth visits and free shipping

7.4

MadeMed

Compounded GLP-1 in both injection and oral forms

8.3

Found

Mainstream telehealth GLP-1 access

1st Optimal vs Alegro Health: FAQ

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