Review (2026)
Independently researched · scored on our public 5-criteria methodology
Maps your hormones within metabolic, thyroid and lifestyle context. Thorough, with higher upfront labs.
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1st Optimal has no signup link: see Male Excel →Summarize this page with
Short answer
1st Optimal scores 8.1/10 (#2 of 39 clinics). We rate it Best for Comprehensive Labs. $169/mo with a 120-day minimum, billed monthly is what 1st Optimal charges today, but its own page never says whether that rate holds. We looked for a sentence confirming it rises, or confirming it doesn't, and there is neither. Treat it as unconfirmed rather than fixed, and ask before you give a card.
Our verdict
1st Optimal earns 8.1/10 and ranks #2 of 39 TRT clinics we've scored. We rate it Best for Comprehensive Labs. Maps your hormones within metabolic, thyroid and lifestyle context. Thorough, with higher upfront labs.
How much does 1st Optimal cost?
1st Optimal starts at $169/mo with a 120-day minimum, billed monthly. Verified 2026-10-05.
The $169/mo figure is the "Men's Hormone Care" plan. 1st Optimal's own label for men's hormone and testosterone optimization. Published tiers run $99-$239/mo, but the cheaper ones are different products: $99 is "Weight Loss Care" on the women's track. The plans page sits behind a cookie banner and the men's tier list is a hidden tab, so both are easy to miss.
- Commitment
- 120-day minimum, billed monthly.
Membership is for a minimum of 120 days and will renew automatically unless a membership change request is submitted after the initial 120 days.
(1stoptimal.com, read Oct 14, 2026) - 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.
Members can pause or cancel their memberships through our Membership Change Request, located at Membership Change Request Form. A notice period of the current billing cycle is required. Change requests must be submitted 7 days before the next billing cycle
(1stoptimal.com, read Oct 14, 2026) - HSA and FSA
Yes, you can use your HSA or FSA card for services at 1st Optimal.
(1stoptimal.com, read Oct 16, 2026)
Classified as “Rate holds? Not stated”. See how we classify every clinic's price →
Sources: Pricing verified on 1stoptimal.com
Your first charges with 1st Optimal
What leaves your card and when, on the cheapest plan we price, if a clinician approves you. Figures marked “our arithmetic” are worked out from 1st Optimal's own prices.
- At checkout$169First month
- After 1 month$169Second month
- After 2 months$169Third month
1st Optimal sets a 120-day minimum.
From 1st Optimal's prices, read 2026-10-05.
1st Optimal’s starting price over time
Every change to the starting price we recorded, oldest first:
| Recorded | Starting price |
|---|---|
| Jun 4, 2026 | $166 |
| Aug 28, 2026 | $99 |
| Aug 28, 2026 | $169 |
A change can be the clinic moving its price or us correcting an earlier reading. The full series for every clinic is in price-history.csv.
What changed since we last checked
No change to 1st Optimal’s plan rows or list of states in our record since we started recording them. Changes to its starting price are in the section above.
A change can be 1st Optimal moving a price, or us reading a page we hadn’t read before or correcting an earlier reading. Dates are when the change entered our record.
Before you sign up with 1st Optimal
Each line is from 1st Optimal's own pages or a public record, with the date we read it. Where we hold no reading, the line is left out rather than guessed. Commitment and cancellation terms are in the cost section above.
- 12-month total
- About $2,028 for the first 12 months, by our arithmetic from 1st Optimal's published prices. (checked Oct 5, 2026)
- Lab work
- Before you start: 1st Optimal's pages don't say. Follow-up: 1st Optimal's pages don't say. (1stoptimal.com, read Sep 11, 2026)
Check your state and budget
From 1st Optimal’s own pages as recorded in its review. A monthly figure for a plan billed every few weeks or months is our arithmetic.
Questions to ask 1st Optimal at intake
Each one is here because 1st Optimal’s pages left it open when we read them.
- How do I cancel, and is anything refunded if I stop partway through a plan? We didn't find 1st Optimal's cancellation terms on the pages we read.
- Do you serve my state? 1st Optimal doesn't publish a list of states it can't serve.
- Do I need lab work before starting, and what does it cost? Its pages don't say whether labs are needed or what they cost.
- Is the medication included in this price, or billed separately? We didn't find a statement of what the price covers.
- How do I reach a clinician between visits, and how fast do they reply? We didn't find a published support or messaging commitment.
Quick facts
| Our score | 8.1/10 |
| Starting price | $169/mo with a 120-day minimum, billed monthly |
| Treatment types | injections, peptides, comprehensive labs |
| Availability | Not published. Check before you sign up |
| Insurance | “No, you do not need insurance. In fact, we offer all of our treatments via a cash-based model (FSA/HSA are accepted).” (1stoptimal.com, 2026-10-16) |
| Overall rank | #2 of 39 |
| Price verification | Verified 2026-10-05 |
Is 1st Optimal legit?
How we checked it for this review.
- ✓ Connects you with U.S.-licensed clinicians for evaluation and prescriptions
- ✓ Requires lab work and ongoing monitoring (proper Schedule III handling)
- ✓ Transparent starting price ($169/mo with a 120-day minimum, billed monthly) · Verified 2026-10-05
- ✓ Scored independently on our public methodology. Commissions never move the score
Correction
Correction, 28 August 2026: earlier today we listed 1st Optimal at $99/mo. That figure is the "Weight Loss Care" plan on the clinic's women's track. Not a TRT price, and not the plan a man seeking testosterone therapy would buy. The correct figure is $169/mo for "Men's Hormone Care". We took the first price on the page without checking which product it belonged to. The price and the pricing score have been corrected.
“Testosterone deficiency doesn't kill people as far as we know but it is really an important symptomatic condition that affects quality of life.”
Third-party records
What we found outside 1st Optimal's own site. BBB, its named pharmacy partner (or lack of one), and whether it publishes a real HIPAA notice.
Better Business Bureau
No BBB profile found for 1st Optimal (checked 2026-08-30).
Search worked, zero matching results. Genuine absence.
Pharmacy partner
1st Optimal does not name the specific pharmacy that fills or compounds its medications (checked 1stoptimal.com, 2026-08-30). That is the norm for this category, not unusual for 1st Optimal specifically. Most providers we've checked don't name one either.
HIPAA disclosure
Published. A real HIPAA-specific notice, checked 2026-08-30. Real Notice of Privacy Practices, naming "1st Optimal and its Affiliated Covered Entity members."
Sources: Privacy policy
Choose 1st Optimal if
- + You want best for comprehensive labs
- + You're looking for injections
- + You're looking for peptides
Skip 1st Optimal if
- − Doesn't say what lab work costs
- − Doesn't name the pharmacy that fills your prescription
1st Optimal pros & cons
What we like
- + Deep, context-rich lab work
- + Metabolic & thyroid screening
- + Peptide options available
What could be better
- − Doesn't say what lab work costs
- − Doesn't name the pharmacy that fills your prescription
Score breakdown
How 1st Optimal works
- 1. Online intake. Complete a medical questionnaire about your symptoms and health history.
- 2. Bloodwork. Because testosterone is a Schedule III controlled substance, you'll do lab testing (at-home kit or a local lab). Never a questionnaire-only prescription.
- 3. Clinician review & delivery. A licensed clinician reviews your labs and, if appropriate, prescribes treatment shipped discreetly to your door, with ongoing monitoring.
Frequently asked questions
How much does 1st Optimal cost?
1st Optimal starts at $169/mo with a 120-day minimum, billed monthly (verified 2026-10-05). Final cost depends on your protocol and medication.
What does 1st Optimal cost over 12 months?
About $2,028 for the first 12 months, by our arithmetic from 1st Optimal's published prices. (Read 2026-10-05.)
Does 1st Optimal require blood work, and who pays for it?
Yes: testosterone is a controlled substance and needs lab monitoring. Before you start: 1st Optimal's pages don't say. Follow-up: 1st Optimal's pages don't say. (Read 2026-09-11.)
Is 1st Optimal available in my state?
1st Optimal doesn't publish a state-by-state availability list we could verify, so we don't claim one. Confirm with the clinic before you pay.
Does 1st Optimal take insurance?
1st Optimal states “No, you do not need insurance. In fact, we offer all of our treatments via a cash-based model (FSA/HSA are accepted).” on 1stoptimal.com (read 2026-10-16).
Does 1st Optimal require a minimum commitment?
120-day minimum, billed monthly. 1st Optimal's wording: "Membership is for a minimum of 120 days and will renew automatically unless a membership change request is submitted after the initial 120 days." (read Oct 14, 2026).
How do I cancel 1st Optimal?
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. 1st Optimal's wording: "Members can pause or cancel their memberships through our Membership Change Request, located at Membership Change Request Form. A notice period of the current billing cycle is required. Change requests must be submitted 7 days before the next billing cycle" (read Oct 14, 2026).
Can I pay 1st Optimal with an HSA or FSA card?
1st Optimal says: "Yes, you can use your HSA or FSA card for services at 1st Optimal." (read Oct 16, 2026). Whether a given purchase qualifies is up to your plan administrator.
About the treatments 1st Optimal offers
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Alexandru Vieru · Founder & Editor
Alexandru Vieru is the founder and editor of TRT Picks. He independently researches and verifies every clinic's pricing, treatment options and policies, and maintains the 5-point scoring model used across the site. He is not a licensed medical professional. Every clinical claim is sourced to a primary reference (FDA, manufacturer pages, or peer-reviewed studies), and nothing here is medical advice.
Verified 2026-10-05. Scores are derived from our documented methodology and are never influenced by affiliate commissions. Educational information only. Not medical advice.