Head-to-head · WeighScore
1st Optimal vs Tell Her Doc
The verdict
1st Optimal takes it — 61.6/100 to 57.2/100.
1st Optimal grades higher on WeighScore, our editorial score across cost value, dose & formulation, clinical oversight, labs & monitoring, fulfillment and contract terms. 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.
We may earn a commission if you start care through some of these links, at no extra cost to you. It never moves the WeighScore, which is the weighted average of the six factors shown for every provider, and what we write about a provider is the same either way. See our disclosure.
Factor by factor
The same six graded dimensions, side by side. See the methodology.
The numbers
| Metric | 1st Optimal | Tell Her Doc |
|---|---|---|
| WeighScore | 61.6/100 | 57.2/100 |
| Grade | C | C |
| Scorecard rank | #291 | #404 |
| Semaglutide | Not disclosed | $269/mo (microdose tier, plus a separate fee, compounded) |
| Tirzepatide | Not disclosed | Not disclosed |
| Coverage | Coverage not published | All 50 states |
| Brand-name access | Compounded only | Compounded only |
| Oral / sublingual | Yes | Yes |
Graded #291 · C
Strengths
- 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
Where it loses points
- 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
Graded #404 · C
Strengths
- Full compounded GLP-1 lineup — semaglutide and tirzepatide in injection, oral and orally-dissolving-tablet forms, plus microdoses
- Names its compounding pharmacy partner (Casa Pharma RX), which is independently listed in our pharmacy registry
- No monthly membership, cancel anytime, free discreet shipping; HSA/FSA eligible with buy-now-pay-later plans
- Serves patients in all 50 states via a private online consultation
Where it loses points
- 'All sales are final' — no refunds once medication has left the pharmacy
- Exact price is plan-dependent, shown after you pick a product; advertised 'starting at $269', with a lower $140 intro on oral semaglutide
- References LegitScript but without an independently verifiable seal — we couldn't confirm certification
- Compounded semaglutide and tirzepatide only — no brand-name (Wegovy/Zepbound) options
- Compounded GLP-1s are not FDA-reviewed or approved — a different evidence and regulatory tier than brand-name
Also worth a look
Neither is our top-graded pick — CoreAge Rx leads the scorecard
Across all 499 providers, CoreAge Rx grades highest at 91.8/100 (A−). Top of the scorecard: flat transparent pricing, both molecules, nationwide — no teaser-rate games.
Pricing/verification reflect each provider's public disclosures at last grading; the WeighScore is our editorial judgment per the methodology. Prices change — confirm on each provider's site. Not medical advice; see our disclosure.