1st Optimal vs Strut Health
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 program
Visit 1st Optimal →
1st Optimal and Strut 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, Strut Health starts at $99/mo, and Strut Health edges ahead overall (8.0 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.
Strut Health
Auto Refill starting at $99, Save 21%; one-off price higher
Auto Refill starting at $149, Save 13%
Auto Refill starting at $199, Save 17%; one-off 30-day supply $239
Auto Refill starting at $199, Save 14%; page also shows 30 DAY SUPPLY $325 compare-at price
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What’s included
1st Optimal
Inclusions not disclosed.
Strut Health
What the monthly price covers
Medication
Included
Provider visits
Included
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
Strut Health
8.0/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Strut Health |
|---|---|---|
| Starting Price | — | $99/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | 49 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| 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 Strut Health
Strut Health offers LegitScript + ACHC-accredited compounded semaglutide and tirzepatide in both injectable and oral lozenge formats, shipping to 49 states. Board-certified US physicians handle prescribing with free unlimited follow-up messaging, but eligibility is gated behind a 'medical necessity' clinician determination that isn't publicly defined.
Read our full Strut 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
Strut Health
What we like
- Both LegitScript and ACHC accredited — pharmacy oversight most compounded GLP-1 providers don't carry
- Oral lozenge option for semaglutide ($99/mo) and tirzepatide ($199/mo) — an injection-free alternative
- Auto-refill pricing saves 13–21% vs one-off orders
- Free unlimited follow-up messaging with board-certified US physicians
- Ships to 49 states (only Arkansas excluded)
Watch-outs
- Requires a "medical necessity" review, but the criteria aren't published — you can't self-screen before paying for a consult
- Compounded only — no FDA-approved Ozempic, Wegovy, Zepbound, or Mounjaro
- Pharmacy partners aren't named — you can't verify the compounding source
- No insurance accepted — cash pay only
- Phone consultation requirement varies by state
Our Verdict
Strut Health edges out 1st Optimal with a higher overall score of 8.0/10 and is particularly strong for oral-lozenge compounded GLP-1 access. 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 Strut Health if…
You want oral-lozenge compounded GLP-1 access and a starting price around $99/mo.
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Get started →1st Optimal vs Strut Health: 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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