1st Optimal vs Keeps TRT: Which TRT Clinic Is Better in 2026?
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Short answer
1st Optimal wins overall, scoring 8.1/10 vs 6.3/10, mainly on transparency and treatment options.
1st Optimal wins overall, scoring 8.1/10 vs 6.3/10.
Maps your hormones within metabolic, thyroid and lifestyle context. Thorough, with higher upfront labs.
from $169/mo with a 120-day minimum, billed monthly
Visit 1st Optimal
Keeps TRT
Well-known brand (from hair loss) with a simple digital sign-up. A promotional $49 covers labs, consult and plan, but ongoing treatment cost isn't shown until after the eligibility quiz.
Price on consultation
Visit Keeps TRT1st Optimal vs Keeps TRT, side by side
| Feature | 1st Optimal | Keeps TRT |
|---|---|---|
| Our score | 8.1/10 | 6.3/10 |
| Starting price | $169/mo with a 120-day minimum, billed monthly | Price on consultation |
| Treatment types | injections, peptides, comprehensive labs | injections, oral testosterone (ODT), enclomiphene |
| Best for | Best for Comprehensive Labs | Best for Beginners |
| Overall ranking | #2 | #27 |
| Price & Value (25%) | 7.5 | 6.0 |
| Clinical Oversight (25%) | 8.5 | 7.0 |
| Treatment Options (20%) | 8.0 | 6.0 |
| User Experience (15%) | 8.0 | 8.5 |
| Transparency (15%) | 8.5 | 4.0 |
Sources: 1st Optimal pricing verified on 1stoptimal.com, Keeps TRT pricing verified on jointitan.com
1st Optimal vs Keeps TRT: plans, price and what's included
Both offer injections. Only 1st Optimal lists peptides and comprehensive labs; only Keeps TRT lists oral testosterone (ODT) and enclomiphene.
| 1st Optimal | Keeps TRT | |
|---|---|---|
| Starting price | from $169/mo with a 120-day minimum, billed monthly | Price on consultation |
| Plans it publishes | One published rate | One published rate |
| Commitment | 120-day minimum, billed monthly. (1stoptimal.com, read Oct 14, 2026) | No minimum term stated. The membership fee is charged every 84 days and medication every 12 weeks until you cancel. (jointitan.com, read Oct 14, 2026) |
| Labs | Not stated by the clinic (1stoptimal.com, read Sep 11, 2026) | Initial and follow-up labs included (jointitan.com, read Sep 11, 2026) |
| What the price covers | Rate holds? Not stated | Total not verified |
| First month | $169 | Not modeled |
| 12 months, no commitment | $2,028 | Not modeled |
| Cancelling | After 120 days, submit the membership change request form at least 7 days before the next billing date. Prescribed treatments and telemedicine services are not refunded. (1stoptimal.com, read Oct 14, 2026) | Email trt@keeps.com at least 48 hours before the current billing cycle ends. Membership and medication fees are not refunded once charged. (jointitan.com, read Oct 14, 2026) |
| Formats | injections, peptides, comprehensive labs | injections, oral testosterone (ODT), enclomiphene |
| States served | State list not on file | State list not on file |
First-month and 12-month figures come from our 12-month cost model, at each clinic's no-commitment rate. “About per year” for a prepaid plan is our arithmetic on the billing cycle the clinic prints.
Who should pick which
Pick 1st Optimal if
- you want peptides or comprehensive labs, which Keeps TRT does not list
Pick Keeps TRT if
- you want oral testosterone (ODT) or enclomiphene, which 1st Optimal does not list
- you want every lab panel inside the price
Pros & cons
1st Optimal
Pros
- + Deep, context-rich lab work
- + Metabolic & thyroid screening
- + Peptide options available
Cons
- − Weaker on User Experience (8.0 vs 8.5/10)
Keeps TRT
Pros
- + Trusted, established brand
- + Fast digital onboarding
- + $49 promotional entry covers bloodwork, consult and plan
Cons
- − Weaker on Transparency (4.0 vs 8.5/10)
- − Weaker on Treatment Options (6.0 vs 8.0/10)
- − Weaker on Price & Value (6.0 vs 7.5/10)
The bottom line
After scoring all 39 clinics on our 5-criterion rubric (price & value, clinical oversight, treatment options, user experience and transparency), 1st Optimal (8.1/10) comes out ahead of Keeps TRT (6.3/10). But the right choice still depends on what matters most to you.
Choose 1st Optimal if you want best for comprehensive labs. From $169/mo with a 120-day minimum, billed monthly.
Visit 1st Optimal →Choose Keeps TRT if you want best for beginners. Price on consultation.
Visit Keeps TRT →Editor's overall pick
Not sold on either? Our highest-rated clinic overall is Male Excel (8.1/10), from $99/mo membership; medication billed on top. Read the review →
Ready to start TRT?
Our verdict for this matchup is 1st Optimal.
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How we score: every clinic is rated on five weighted criteria from documented evidence. Prices are checked weekly by an automated job against each clinic's live page; a price unconfirmed for 45 days is automatically relabeled “Last confirmed” instead of “Verified.” Scores are never influenced by affiliate commissions. “Visit” buttons are affiliate links that support our work. Educational information only. Not medical advice.