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 programStrut Health
Best for oral-lozenge compounded GLP-1 accessStarting at $99/mo
Side-by-Side Comparison
| Feature | 1st Optimal | Strut Health |
|---|---|---|
| Overall Score | 6.7/10 | ✓8.1/10 |
| Starting Price | — | $99/mo |
| Editorial Rating | 3.4 ★ /5 | ✓4.1 ★ /5 |
| Features | ✓8 features | 6 features |
| States Available | 0 | ✓49 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| 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
Strut Health
Pros
- ✓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)
Cons
- ✗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 8.1/10 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.
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.
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.