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Feel like yourself again, backed by real labs, not guesswork

Personalized hormone and metabolic care built around your data. Lab testing, physician-guided treatment, and ongoing coaching to help you perform at your best.
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Functional Health Coaching • Lab based treatment Plans • Guided Medical Care Nutrition & Lifestyle, Supplementation, and Activity Support.

Backed by trusted certifications and medical standards

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Tired of feeling "off"

but not getting real answers?

Constant fatigue no matter how much you sleep
Weight that won't move despite dieting
Low drive, mood swings, or lack of motivation
Brain fog affecting focus and performance
Digestive issues like bloating or constipation
Feeling drained even after a full night's sleep
Find Out What’s Actually Going On

Takes 2 minutes. Get personalized insights based on your symptoms

For Women

Perimenopause, menopause, hormone balance, weight loss, and energy optimization with personalized treatment plans
Explore women's care

For Men

Testosterone therapy, peptide optimization, weight loss, and performance-focused care built around your labs.
Explore men's care
Men's

Testosterone
Men's

Weight
Loss
Men's

Peptides
Men's

Gut
Health
Men's

Testosterone
Men's

Weight Loss
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Peptides
Men's

Gut Health

How It Works

Book Your Consult
Talk with our team about your symptoms, goals, and health history
Complete Your Lab Testing
Quick, hassle-free testing either at home or through a local lab near you
Get Your Personalized Plan
Your provider reviews your results and builds a treatment plan tailored to your body
Ongoing Coaching and Support
Track progress, adjust treatment, and stay supported every step of the way
Treatment timelines vary, but many patients begin noticing improvements within the first few weeks
Start with a Consultation

Real Results From Real Patients

Trusted by patients across the U.S.
Flat mood
Sharp & driven
Cognitive clarity, ambition, and performance restored
Patrick G.
Low T
Normal
Reached goal weight and improved metabolic health in 5 months
Marcus R.
438
291 lbs
Lost 150 lbs in 12 months with a personalized plan and ongoing support
Jessy P.
Low Hormones
High Energy
"Through detailed blood work and expert guidance, 1st Optimal helped me address underlying hormone deficiencies. The result was renewed energy, improved well-being, and a new lease on life."
Julie L.
Waiting Weeks
Same-Day Answers
"The process was surprisingly fast and efficient. From lab results to a detailed consultation, 1st Optimal provided the clarity and support I needed without the usual delays."
Vanessa L.
Training Hard
Recovering Smarter
"1st Optimal helped me recover faster, reduce soreness, and maintain higher energy levels. The difference showed up not just in how I felt, but in how I performed."
Junior G.
Quick Fixes
Sustainable Energy
"1st Optimal helped me move beyond temporary solutions with a personalized health strategy. The result has been better recovery, improved performance, and lasting energy."
Justen G.
Data
Dominance
"By tailoring every aspect of the plan to my lab results, 1st Optimal helped me unlock better focus, faster recovery, and measurable physical results."
Ryan W.
Below Par
Performing Better Than Ever
"Since starting with 1st Optimal, I've seen improvements across the board—from recovery and sleep to energy and overall well-being. I simply feel better every day."
Jeff A.
Brain Fog
Clarity
"1st Optimal helped me understand what was happening and guided me every step of the way. The results have been life-changing, I feel amazing and more like myself than ever before."
Brandy D.

Watch Real Patient Stories
and Transformations

Common Questions Before You Get Started

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1st Optimal specializes in telehealth medical services, including lab tests, hormone replacement therapy, peptide treatments, and weight loss solutions tailored to your needs through a membership-based model. We focus on enhancing performance, managing hormones, and effectively achieving weight loss.
Hormone replacement therapy (HRT) and Testosterone replacement therapy (TRT) may be suitable if you’re experiencing symptoms like chronic fatigue, mood swings, or low energy. Our team will conduct thorough testing to determine if HRT/TRT is the right path for you through a complimentary discovery call.
To begin your journey, book your intake call. After assessing your needs, we’ll guide you through diagnostic testing and create a personalized treatment plan to optimize your health.
Your membership includes all medical oversight and consultations, shipping costs, and medical supplies. You also have access to our treatments and services at a reduced members-only rate and receive priority booking and services.
During your consultation, our medical team will review your medical history, discuss your symptoms, and recommend appropriate treatments based on your goals. Whether it’s hormone therapy, weight loss, or other wellness solutions, we ensure a comprehensive approach to your health.

Not sure where to start?

Take our quick 2-minute health quiz and we'll guide you toward the right labs and next steps
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A smarter, lab-driven approach to your health

We combine functional medicine and health coaching to align your biology with your daily habits. Every plan is built from your labs, symptoms, and goals.
Medical oversight you can trust
Licensed providers guide your care and ensure every treatment is safe, compliant, and based on your lab results
Coaching that keeps you on track
Work with experienced health coaches to improve nutrition, lifestyle, and long-term results
Plans built for your body
Custom protocols based on your labs, symptoms, and goals, with ongoing adjustments as you progress

The 1st Optimal Podcast

Explore expert conversations on hormones, metabolism, weight loss, peptides, gut health, and longevity. Get practical insights to help you feel better, age stronger, and take control of your health.

Why Gut Health Affects Your Hormones, Brain Fog, Energy and Weight Loss with Dr. Cassie Smith

In this episode, Dr. Cassie Smith sits down with our host, Joe Miller, founder of First Optimal, to discuss the powerful connection between gut health, hormones, metabolism, and overall wellness. We talk about root causes, advanced testing, sustainable lifestyle changes, and why your symptoms may be telling you more than your lab results.

Latest Episode
1 month ago 53:33

Why Some Patients Heal Faster — Dr. Cassie Smith Reveals the Truth

5 months ago 01:15:01

The Hormone Reset That Actually Works — Shauna Theresa Butler Explains

5 months ago 49:03

Why Most People Fail at Fitness — The Mindset Fix You Need with Coach Travis Wallace

5 months ago 01:02:25

The Hidden Reason Your Knees, Hips & Back Keep Hurting with Dr. Mani Veerappan

2 months ago 57:56

Food Noise Was Blocking Her Weight Loss Until This Changed - A Client Story: Kristy Olendorf

2 months ago 26:24

What Your Poop REALLY Reveals About Your Gut Health — Liz Roman, BC-HPP

2 months ago 1:15:05

Stop Wasting Time in the Gym! The BFR Method That Actually Builds Strength - Dr. Michael MacPherson

2 months ago 58:25

Is Your Gut Sabotaging Your Fat Loss Goals? Becca Chilczenkowski Shares How to Fix It!

3 months ago 1:37:13

Reclaim Your Energy and Life: Coach Tim Washburn’s Proven Recovery Methods

3 months ago 43:35

Chewjitsu Strength Coach Reveals MMA & BJJ Performance Secrets!

3 months ago 1:08:17

Resources & education

Optimal Reading

Perimenopause Fatigue: Why Sleep May Matter More Than Hormone Levels Alone
  • Women’s Health & Hormones

Perimenopause Fatigue: Why Sleep May Matter More Than Hormone Levels Alone

Perimenopause fatigue can feel different from ordinary tiredness. You may wake up already drained, rely on caffeine to get through the morning, struggle to focus in the afternoon, and still have trouble sleeping when your head finally reaches the pillow. Hormonal changes can contribute. But fatigue during perimenopause is rarely explained by one estradiol, progesterone, […]

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Constipation, Nausea and Reflux on GLP-1s: Practical Management
  • Peptide Therapy

Constipation, Nausea and Reflux on GLP-1s: Practical Management

GLP-1 medications can be highly effective for weight loss and blood sugar management, but the digestive side effects can make treatment difficult. Constipation, nausea, heartburn, belching, bloating, and uncomfortable fullness are among the most common complaints. These symptoms often appear when someone starts treatment, increases the dose, eats beyond their new fullness signals, or combines […]

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Metabolic Adaptation After Weight Loss: Is Your Metabolism Really “Broken”?
  • Articles

Metabolic Adaptation After Weight Loss: Is Your Metabolism Really “Broken”?

You lost weight, followed the plan, and watched the scale move in the right direction. Then progress slowed. Hunger increased. Workouts felt harder. The calorie target that once produced results suddenly seemed to do nothing. It is easy to conclude that your metabolism is “broken.” That phrase is understandable, but it is usually not accurate. […]

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The Peptide Gray Market: Risks of “Research Use Only” Products
  • Peptide Therapy

The Peptide Gray Market: Risks of “Research Use Only” Products

Peptide therapy has moved from research laboratories and specialty medicine into mainstream conversations about recovery, weight management, metabolic health, performance, and longevity. That growing interest has also created a large online gray market. Websites now sell injectable compounds labeled “research use only,” “not for human consumption,” or “laboratory purposes only,” often while surrounding those disclaimers […]

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Exercise, Inflammation, and Insulin Sensitivity: Why Walking and Strength Training Work Better Together
  • Metabolic Health

Exercise, Inflammation, and Insulin Sensitivity: Why Walking and Strength Training Work Better Together

Walking and strength training affect metabolic health in different but complementary ways. Walking helps increase daily energy use, improve cardiovascular fitness, reduce prolonged sitting, and manage blood sugar after meals. Strength training builds and preserves skeletal muscle, which is one of the body’s largest sites for glucose use and storage. Combining both forms of movement […]

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Anti-Inflammatory Movement and Strength Guide
  • Metabolic Health

Anti-Inflammatory Movement and Strength Guide

Regular movement, aerobic exercise, and strength training can support a healthier inflammatory response while improving insulin sensitivity, cardiovascular fitness, muscle mass, mobility, and metabolic health. The most effective plan does not require punishing workouts, advanced equipment, or perfect adherence. Start with daily movement, gradually increase weekly walking or aerobic activity, and train the major muscle […]

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