TTRT Picks

1st Optimal vs Keeps TRT: Which TRT Clinic Is Better in 2026?

15 clinics scored independently✓ Prices re-verified monthly✓ Commissions never move our rankings
Our pick: 1st Optimal

1st Optimal wins overall, scoring 7.6/10 vs 7.5/10. If price is your priority, Keeps TRT is cheaper at $110/mo.

Winner
#11 of 15

1st Optimal

7.6

Maps your hormones within metabolic, thyroid and lifestyle context — thorough, with higher upfront labs.

from $166/mo

Visit 1st Optimal
#12 of 15

Keeps TRT

7.5

Well-known brand (from hair loss) with a simple digital sign-up process.

from $110/mo

Visit Keeps TRT

1st Optimal vs Keeps TRT, side by side

Feature1st OptimalKeeps TRT
Our score7.6/107.5/10
Starting price$166/mo$110/mo
Treatment typesinjections, peptides, comprehensive labsinjections, cream
Best forBest for Comprehensive LabsBest for Beginners
Overall ranking#11#12
Price & Value (25%)6.08.0
Clinical Oversight (25%)8.57.0
Treatment Options (20%)8.07.0
User Experience (15%)8.08.5
Transparency (15%)8.07.0

Pros & cons

1st Optimal

Pros

  • + Deep, context-rich lab work
  • + Metabolic & thyroid screening
  • + Peptide options available

Cons

  • Weaker on Price & Value (6.0/10)
  • Weaker on Treatment Options (8.0/10)
  • Weaker on User Experience (8.0/10)

Keeps TRT

Pros

  • + Trusted, established brand
  • + Fast digital onboarding
  • + Competitive entry price

Cons

  • Weaker on Clinical Oversight (7.0/10)
  • Weaker on Treatment Options (7.0/10)
  • Weaker on Transparency (7.0/10)

The bottom line

After scoring all 15 clinics on price, clinical oversight, treatment options, experience and transparency, 1st Optimal (7.6/10) comes out ahead of Keeps TRT (7.5/10) — but the right choice depends on what matters most to you.

Choose 1st Optimal if you want best for comprehensive labs — from $166/mo.

Visit 1st Optimal

Choose Keeps TRT if you want best for beginners — from $110/mo.

Visit Keeps TRT

Editor's overall pick

Not sold on either? Our highest-rated clinic overall is Defy Medical (8.2/10) from $200/mo — read the review →

Ready to start TRT?

Our verdict for this matchup is 1st Optimal.

Related comparisons

Defy Medical vs 1st OptimalDefy Medical vs Keeps TRTHone Health vs 1st OptimalHone Health vs Keeps TRTPeter MD vs 1st OptimalPeter MD vs Keeps TRT

Top picks

Defy Medical

8.2

from $200/mo

Hone Health

8.1

from $129/mo

Peter MD

8.1

from $79/mo

How we score: every clinic is rated on five weighted criteria from documented evidence, re-verified monthly. Scores are never influenced by affiliate commissions. “Visit”/“Try” links may be affiliate links that support our work. Educational information only — not medical advice.