1st Optimal vs Signos
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 →
Signos
Best for: Pairing compounded semaglutide with an FDA-cleared glucose monitor + app
Visit Signos →1st Optimal and Signos 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 $199/mo, and Signos edges ahead overall (7.5 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.
Signos
Signos+ GLP-1 bundle (tirzepatide OR semaglutide) from $199/mo; includes CGM system
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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
Signos
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
Signos
7.5/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Signos |
|---|---|---|
| Starting Price | ✓$99/mo | $199/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | ✓ Yes |
| 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 Signos
Signos (Signos+) is a metabolic-health platform that bundles clinician-prescribed compounded GLP-1 (semaglutide) with an FDA-cleared continuous glucose monitor (CGM) and app — pairing the medication with real-time glucose data and coaching so users understand and sustain their weight loss. The program starts at $199/mo on a 6-month plan, includes free shipping, and is HSA/FSA eligible. It is pitched as the same price as medication alone, with the CGM added.
Read our full Signos 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
Signos
What we like
- 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
Watch-outs
- 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 semaglutide with an FDA-cleared glucose monitor + app. 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 Signos if…
You want Pairing compounded semaglutide with an FDA-cleared glucose monitor + app and a starting price around $199/mo.
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Budget-conscious shoppers
From $93/mo
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Compounded GLP-1 alongside NAD+, peptide and longevity add-ons
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Get started →1st Optimal vs Signos: 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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