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1st Optimal vs Nova MD

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

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6.7

1st Optimal

Best for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program
★★★☆☆3.4
Semaglutide GLP-1Tirzepatide GLP-1Oral tablet optionAt-home lab testing
Visit 1st Optimal
7.2

Nova MD

Best for lowest 3-month compounded pricing with an explicit microdose program
★★★3.6

Starting at $125/mo

CompoundedMicrodose OptionsSemaglutideTirzepatide
Visit Nova MD

Side-by-Side Comparison

Feature1st OptimalNova MD
Overall Score6.7/107.2/10
Starting Price$125/mo
Editorial Rating3.4 ★ /53.6 ★ /5
Features8 features8 features
States Available00
Compounded✓ Yes
Brand Name
FSA/HSA Accepted✓ Yes
FDA WarningsNoneNone

Pros & Cons

1st Optimal

Pros

  • 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

Cons

  • 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

Nova MD

Pros

  • On-page pricing published for all four SKUs (semaglutide and tirzepatide, 1- and 3-month)
  • $125/mo semaglutide and $199/mo tirzepatide 3-month plans rank among the cheapest in the market
  • $50 off first tirzepatide order shown publicly
  • Explicit microdose / low-dose program for both semaglutide and tirzepatide
  • Broader menu (sermorelin, NAD+, glutathione, enclomiphene) for longevity alongside GLP-1
  • FSA/HSA eligible and cancel-anytime billing with same-day doctor review

Cons

  • Legal entity name and state of incorporation not disclosed
  • Compounding pharmacy not named — only 'accredited facilities'
  • LegitScript certification not confirmed (only 'Licensed US Providers' claims)
  • Per-state availability not listed
  • Compounded only — no brand-name Wegovy, Zepbound, Mounjaro, or Ozempic
  • Lab work and ongoing monitoring aren't clearly addressed
  • Patient count (1,241+) is an unverified marketing claim

Our Verdict

Winner: Nova MDScore: 7.2/10

Nova MD edges out 1st Optimal with a higher overall score of 7.2/10 and is particularly strong for lowest 3-month compounded pricing with an explicit microdose program. 1st Optimal remains a solid alternative, especially if you're looking for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

Glossary references

Key terms in this article, linked to their canonical definitions.

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Wegovy®, Ozempic®, and Rybelsus® are trademarks of Novo Nordisk A/S. Mounjaro® and Zepbound® are trademarks of Eli Lilly and Company. All other product names and trademarks referenced on this page belong to their respective owners. WeightLossRankings.org is not affiliated with any pharmaceutical manufacturer. See trademark disclaimer.