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1st Optimal vs Nirwana 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
Nirwana Health logo

Nirwana Health

7.2
★★★3.6/5

Best for: Shoppers wanting oral or injectable compounded GLP-1 with no membership and cheaper multi-month plans

Visit Nirwana Health

1st Optimal and Nirwana 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, Nirwana Health starts at $149/mo, and Nirwana Health edges ahead overall (7.2 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

Pricing not publicly listed.

Nirwana Health

MonthlyCompounded
$149/mo
semaglutide

Weekly compounded injection, month-to-month subscription $149/mo; 3-month $133/mo, 6-month $99/mo; 1-month one-time $199; oral semaglutide $199/mo. $50 off with code LOOSE50.

MonthlyCompounded
$229/mo
tirzepatide

Weekly compounded injection, month-to-month subscription $229/mo; 6-month as low as $133/mo; 1-month one-time $279; oral tirzepatide $249/mo.

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What’s included

1st Optimal

Inclusions not disclosed.

Nirwana Health

What the monthly price covers

Medication

Included

Provider visits

Included

Shipping

Not disclosed

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

Nirwana Health

7.2/10

Value25%

6.5A
vs
B
7.3

Effectiveness25%

7.0A
vs
B
7.5

User Experience15%

6.5A
vs
B
7.5

Trust & Safety15%

6.5A
vs
B
6.8

Accessibility10%

6.5A
vs
B
7.0

Support10%

7.4A
vs
B
7.0

Features & Coverage

Feature1st OptimalNirwana Health
Starting Price$149/mo
Features8 features8 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 Nirwana Health

Nirwana Health (nirwanahealth.com) is a telehealth service offering compounded GLP-1 weight loss plus hair, sexual-wellness, and longevity care through licensed providers. It offers compounded semaglutide and tirzepatide as weekly injections and as oral tablets, with month-to-month, quarterly, and 6-month plans and no membership fee. Semaglutide injection runs $149/mo month-to-month (as low as $99/mo on a 6-month plan) and tirzepatide $229/mo; oral versions are $199 and $249/mo. It advertises a $50-off code, though the prescribing entity, pharmacy, and states are not published.

Read our full Nirwana 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

Nirwana Health

What we like

  • Offers compounded semaglutide and tirzepatide as both weekly injections and oral tablets
  • Transparent, published pricing with month-to-month, quarterly, and 6-month plans and no membership fee
  • Multi-month plans cut the per-month cost sharply (semaglutide as low as $99/mo, tirzepatide as low as $133/mo)
  • Advertises a $50-off code (LOOSE50) and covers weight loss plus hair, sexual-wellness, and longevity care
  • Also lists a retatrutide option and custom dosing plans for higher needs

Watch-outs

  • Prescribing medical group and compounding pharmacy are not named on the site
  • States of operation are not published; confirm eligibility during intake
  • Says it is 'LegitScript certified' but no verifiable seal is shown, so the claim is unconfirmed
  • Compounded semaglutide and tirzepatide are not FDA-approved finished products

Our Verdict

Winner: Nirwana Health

Nirwana Health edges out 1st Optimal with a higher overall score of 7.2/10 and is particularly strong for Shoppers wanting oral or injectable compounded GLP-1 with no membership and cheaper multi-month plans. 1st Optimal remains a solid alternative, especially if you're looking for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

Choose 1st Optimal if…

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

Choose Nirwana Health if…

You want Shoppers wanting oral or injectable compounded GLP-1 with no membership and cheaper multi-month plans and a starting price around $149/mo.

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1st Optimal vs Nirwana Health: FAQ

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