1st Optimal vs Signos
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for Patients wanting GLP-1 therapy within a lab-driven functional-medicine programSignos
Best for Pairing compounded GLP-1 (semaglutide) with an FDA-cleared continuous glucose monitor and appStarting at $199/mo
Side-by-Side Comparison
| Feature | 1st Optimal | Signos |
|---|---|---|
| Overall Score | 6.7/10 | ✓7.5/10 |
| Starting Price | — | $199/mo |
| Editorial Rating | 3.4 ★ /5 | ✓3.8 ★ /5 |
| Features | 8 features | 8 features |
| States Available | 0 | 0 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | ✓ Yes |
| FDA Warnings | None | None |
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
Signos
Pros
- ✓Bundles compounded GLP-1 (semaglutide) with an FDA-cleared CGM and app — glucose-guided weight loss, not just medication
- ✓Starting at $199/mo on a 6-month program, with the CGM included at no extra cost
- ✓Free rapid shipping; HSA/FSA eligible
- ✓Real-time glucose insights and app coaching to help sustain results after GLP-1
Cons
- ✗Compounded GLP-1s are not FDA-approved finished products
- ✗Headline price is a 6-month-program rate, not month-to-month
- ✗Only semaglutide is shown in the program; tirzepatide availability is not confirmed
- ✗Compounding pharmacy partner and state availability are not published on the landing page
Our Verdict
Signos edges out 1st Optimal with a higher overall score of 7.5/10 and is particularly strong for Pairing compounded GLP-1 (semaglutide) with an FDA-cleared continuous glucose monitor and app. 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.
- 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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Or see the full category ranking.
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