1st Optimal vs Cielo
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: GLP-1 therapy within a lab-driven functional-medicine program
Visit 1st Optimal →
Cielo
Best for: flat-rate compounded GLP-1 at the lowest 3-month bundle prices
Visit Cielo →1st Optimal and Cielo 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, 1st Optimal starts lower at $99/mo versus $115/mo, and Cielo edges ahead overall (7.6 vs 6.7 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
Care membership only — the GLP-1 medication is billed separately and is not priced.
Cielo
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What’s included
1st Optimal
What the monthly price covers
Medication
Not disclosed
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
Included
Cielo
What the monthly price covers
Medication
Included
Provider visits
Not disclosed
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
Cielo
7.6/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Cielo |
|---|---|---|
| Starting Price | ✓$99/mo | $115/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
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 Cielo
Cielo is a compounded-GLP-1-only telehealth platform offering semaglutide and tirzepatide with no brand-name drugs and no TRT, hair, or mental-health add-ons — a focused, single-purpose alternative to multi-vertical providers. Pricing is flat at every dose, and clinical care is delivered through MD Integrations. Semaglutide starts at $115/month and tirzepatide at $180/month on a 3-month bundle.
Read our full Cielo 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
Cielo
What we like
- Among the lowest 3-month bundle prices in compounded GLP-1 ($115/mo semaglutide)
- Single flat price across all doses simplifies titration planning
- Corporate address (St. Petersburg, FL) and customer-service phone published
Watch-outs
- No LegitScript, NABP .pharmacy, or HIPAA badge on the home page
- Pharmacy partner not named (only 'regulated FDA pharmacy partners')
- State coverage list not published — can't verify all-50-state availability
- Clinical care runs through MD Integrations, a shared third-party network used by many brands
- No brand-name Wegovy or Zepbound option
- Donation page shows 0% next to a 10%-pledge claim — an apparent discrepancy
Our Verdict
Cielo edges out 1st Optimal with a higher overall score of 7.6/10 and is particularly strong for flat-rate compounded GLP-1 at the lowest 3-month bundle prices. 1st Optimal remains a solid alternative, especially if you're looking for GLP-1 therapy within a lab-driven functional-medicine program.
Choose 1st Optimal if…
You want GLP-1 therapy within a lab-driven functional-medicine program and a starting price around $99/mo.
Choose Cielo if…
You want flat-rate compounded GLP-1 at the lowest 3-month bundle prices and a starting price around $115/mo.
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Compounded GLP-1 with unlimited telehealth visits and free shipping
From $88/mo
Get started →MadeMed
Compounded GLP-1 in both injection and oral forms
From $219/mo
Get started →1st Optimal vs Cielo: FAQ
Key terms, explained
New to GLP-1s? Tap any term for a quick, plain-English definition.
- 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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