01
Comprehensive bloodwork
Crystal orders a comprehensive panel including but not limited to: hormones, metabolic, thyroid, liver, kidney, CBC, and PSA where indicated. Not just one marker.
Total & free TSHBG · EstradiolThyroid panelMetabolicPSA
Ontario, Canada · Clinician-led
Feel like youagain.
The White Glove Hormone Optimization Experience
Personalized clinical care. Pharmaceutical-grade medication delivered to your door. 24/7 concierge support. Continuous follow-through — so you never miss an appointment or run out of medication. Anchored by Crystal Troup, NP, your dedicated clinician every visit.
Crystal Troup, NP · Lead Clinician
15+ years · Ontario, Canada
Serving Ontario, Canada
Clinician-led care. Province-wide.
Licensed in Ontario. Pharmaceutical-grade medication delivered anywhere in the province. Same clinician, every visit.
Licensed Ontario Clinicians◆Evidence-Based Protocols◆Pharmaceutical-Grade Medication◆Mailed to Your Door◆Quarterly Bloodwork◆90-Day Prescription Cycles◆Often Covered by Insurance◆Same Clinician Every Visit◆15+ Years Experience◆Licensed Ontario Clinicians◆Evidence-Based Protocols◆Pharmaceutical-Grade Medication◆Mailed to Your Door◆Quarterly Bloodwork◆90-Day Prescription Cycles◆Often Covered by Insurance◆Same Clinician Every Visit◆15+ Years Experience◆
Crystal Troup, NP · Lead Clinician
Built around one clinician.
Tier1 Optimal isn't a prescription mill. Every patient — across every plan — is treated by Crystal Troup, NP. Same clinician from your first consult through every quarterly review.
15+ years of clinical experience across hormone optimization, metabolic health, and women's wellness. Crystal designs your protocol from comprehensive bloodwork — never a single number, never a template — and adjusts every 90 days based on how you actually feel.
“I don't treat lab numbers. I treat people.”
What We Treat
Six pillars. One clinician.
Every Tier1 patient is treated by Crystal Troup, NP — same clinician from your first consult through every quarterly review.
01 · Testosterone Replacement
TRT
Clinician-led testosterone optimization. 90-day cycles. Often covered by insurance.
02 · Women's Hormone Replacement
HRT
Estrogen, progesterone, low-dose testosterone, DHEA, thyroid support — for perimenopause & beyond.
03 · HGH Optimization
HGH
Recovery, body composition, sleep, longevity. Genotropin, Omnitrope.
04 · Medical Weight Loss
Weight Loss
Ozempic, Wegovy, Mounjaro, Contrave — Health Canada approved, monitored quarterly.
05 · ED & Premature Ejaculation
Sexual Health
Discreet, confidential treatment. Mailed in unmarked packaging. Same clinician, every visit.
06 · Hair Loss Treatment
Hair Loss
Finasteride, dutasteride, minoxidil, combination protocols. The earlier you start, the more you keep.
The Difference
The white glove
experience.
A clinician-led, coordinated white glove premium clinical experience with 24/7 AI concierge support so you never have a disruption in treatment, never miss an appointment, and always feel supported.
White Glove Onboarding
From the moment you enroll, Brett personally walks you through onboarding, intake forms, scheduling, and everything you need to get started. You don't have to figure anything out.
White Glove Clinical Care
Crystal sees you personally at every appointment. Same clinician, every visit. No handoffs. No rotating providers. Your protocol is built for YOUR body, reviewed at every visit, and adjusted based on how you actually feel.
White Glove Coordination
Appointments scheduled in advance. Prescription refills coordinated before you run out. Bloodwork requisitions sent to your email. Lab locations looked up for you. The administrative work is handled so you can focus on feeling your best.
White Glove Follow-Through
After every appointment: check-ins. After every bloodwork: a clear protocol update. After every change: someone confirming it's working. This is how optimization is supposed to work.
“
The best time to optimize was five years ago. The second best time is today.
How It Works
Three steps.
No waitlists.
01
Choose Your Plan & Book
Select the membership that fits your goals. Your first month is collected when you book — that's not a sign-up fee, it's your membership starting immediately. Includes your initial consultation and assessment.
02
Initial Consultation with Crystal
Your first clinical appointment with Crystal Troup, NP. She reviews your medical intake, discusses your goals and symptoms, and orders your comprehensive bloodwork panel.
03
Ongoing Care & Optimization
Crystal prescribes in 90-day cycles, so you see her quarterly for bloodwork review, protocol adjustments, and progress check-ins. Same clinician, every visit.
Pharmaceutical-grade medication mailed directly to your door in discreet packaging.
How care actually works
No waitlists. No guesswork.
Your first month's membership covers your initial consultation and comprehensive assessment. Once enrolled, care runs on a structured quarterly cycle — same clinician, every visit.
02
Personalized protocol
Crystal builds your protocol from your lab data and your symptoms — adjusted every 90 days based on how you actually feel.
Evidence-based dosingSame clinician always90-day cycles
03
Quarterly care, mailed to you
Medication ships to your door. Quarterly bloodwork at a lab near you. Crystal reviews, adjusts, and ships the next 90-day supply.
Discreet packagingPharmacy-dispensedRecurring review
Insurance-friendly
Many prescription medications — including testosterone — may be covered up to 100% by your workplace insurance provider. Brett helps you understand your coverage before you commit.
The whole protocol
1 blood test.
4 times a year. That's it.
Q1
Q2
Q3
Q4
Comprehensive panel including but not limited to: hormones, metabolic, thyroid, liver, kidney, CBC, and PSA where indicated. Crystal reviews every result.
What You're Actually Getting
DIY vs. Tier1.
Managing on Your Own
No dedicated clinician. You're on your own.
Tier1 Optimal
Crystal Troup, NP — same clinician, every visit. 15+ years.
Managing on Your Own
Tier1 Optimal
Clinician
No dedicated clinician. You're on your own.
Crystal Troup, NP — same clinician, every visit. 15+ years.
Bloodwork
Most people skip it or get basic panels.
Comprehensive bloodwork panel every quarter. Crystal reviews every result.
Medication Quality
Unknown sources. Unknown purity. Unknown dosing.
Pharmaceutical-grade, pharmacy-dispensed, clinician-dosed.
Monitoring
None. No one is tracking your health.
Structured 90-day cycles. Crystal monitors, adjusts, and follows up.
Delivery
Questionable online orders.
Mailed discreetly to your door. Including controlled substances.
Insurance
You probably don't even know it's covered.
We help you find out. Often covered up to 100% by workplace insurance.
Monthly Cost
$200–400+ for medication alone, no oversight.
From $125/mo for the complete clinical experience.
Why We Do This
People are suffering.
The system is failing them.
We started Tier1 Optimal for one reason: people are suffering and the system is failing them. Men are being prescribed antidepressants when their testosterone is in the gutter. Women are being told their symptoms are "just stress" while their hormones crash. People are gaining weight despite doing everything right because nobody ran the bloodwork that would have shown insulin resistance in five minutes.
These are real people — parents, partners, professionals — who deserve to feel like themselves again.
We are not here to sell memberships. We are here because we have seen what happens when someone finally gets the right care, and it changes everything.
Access, Unblocked
No sign-up fees.
No hidden costs.
No barriers.
Your first month's membership is collected when you book your initial consultation — that's not a sign-up fee, it's your membership starting immediately. Our pricing is transparent because the people who need these treatments need them now, not after months of bureaucracy.
Same Clinician Every Visit
Crystal leads from enrollment through every follow-up.
Pharmaceutical-Grade Medication, Mailed to You
Safer and more effective than self-sourced alternatives.
90-Day Prescription Cycles
Just four blood draws per year. Monthly on Tier1 Pro.
Evidence-Based Protocols
Rooted in lab data, clinical guidelines, and research.
Insurance-Friendly
Many prescription medications, including testosterone, may be covered up to 100% by workplace insurance. Your membership fee is separate from medication costs.
Real Experience
Brett has nearly a decade of personal TRT experience.
No More Waiting
No referrals, no waitlists.
Transparent Pricing
Four plans. No sign-up fees. No hidden costs.
"When you find out your medication is covered by insurance, the care is better than anything you've found on your own, and the whole process takes days instead of months — signing up is a no-brainer."
“
The physical changes were expected. What I didn't anticipate was the absolute return of neural clarity.
— Tier1 Optimal Patient
Patient Experience
Real people.
Real outcomes.
James
Age 38 · TRT
Two years of fatigue and brain fog. His GP told him it was stress and offered antidepressants. Crystal ran a full panel — testosterone in the gutter. Within 8 weeks of his first injection, his energy was back. Three months in, he was sleeping deeper, training harder, and showing up for his family.
“The physical changes were expected. What I didn't anticipate was the absolute return of neural clarity.”
Sarah
Age 47 · HRT
Night sweats, brain fog, two years of being told it was "just perimenopause." One panel with Crystal — estrogen, progesterone, thyroid all out of balance. By month three the night sweats were gone, hot flashes rare, and she was sleeping through the night for the first time in over a year.
“Three months in and I feel like a completely different person.”
Jennifer
Age 42 · Weight Loss
Five years of trying every diet, calorie counting, watching the scale barely move. Crystal ran the bloodwork — significant insulin resistance. Started on tirzepatide with a structured protocol. The food noise quieted in week one. Twenty-eight pounds down by month four with energy and clarity she hadn't felt in a decade.
“I didn't realize how bad I felt until I started feeling good again.”
AI Concierge
Always available
Hi, I'm Ava — your 24/7 AI concierge.
Questions about pricing, scheduling, or insurance? Call or text any time — I'll connect you with Brett or Crystal as needed.
Customer Experience
The best patient experience you've ever had.
We know what it's like to deal with healthcare providers who don't call back, clinics that make you wait months, and customer service that feels like an afterthought. That's exactly why we built Tier1 Optimal differently. From the moment you reach out, every interaction is designed to be fast, personal, and genuinely helpful. Brett answers the phone. Crystal knows your name. Your medication shows up on time. Questions get answered the same day. This is what healthcare should feel like.
Common Questions
Tier1 Optimal, answered.
Tier1 Optimal is a clinician-led online telehealth clinic in Ontario, Canada specializing in hormone optimization (TRT for men and HRT for women), medical weight loss with Ozempic, Wegovy, and Mounjaro, sexual health, and hair loss treatment.
Radical Honesty
Who Tier1 Optimal
is NOT for.
Tier1 Optimal is not for everyone — and we are fine with that.
This is NOT for you if:
- You want a quick prescription without proper clinical assessment. Crystal requires comprehensive bloodwork before prescribing anything. There are no shortcuts.
- You are not willing to complete quarterly bloodwork. Monitoring is not optional — it is how we keep you safe and your protocol optimized.
- You want to skip follow-up appointments. Crystal builds your protocol based on ongoing data. If you disappear for six months, we cannot deliver the results you are looking for.
- You are looking for the cheapest possible option with no clinical oversight. There are cheaper ways to get hormones. There are no cheaper ways to get this level of care.
- You expect guaranteed results without commitment. Optimization is a process. It takes consistency, follow-through, and trust in a structured clinical approach.
This IS for you if:
- You want a licensed clinician who knows your name, your history, and your goals.
- You want pharmaceutical-grade medication with proper monitoring.
- You are willing to invest in your health the right way.
- You want a structured, evidence-based approach — not guesswork.
- You are tired of being dismissed, undertreated, or left waiting.
If that sounds like you, this is a no-brainer. Choose your plan and let Crystal build your protocol.
Less Than $4.17/Day — or $3.77/Day Annually
Stop managing symptoms. Start addressing the cause.
From $125/month on our most popular plan. $3.77/day when you pay annually upfront. For anyone serious about their health, this is a no-brainer.
Book Your Free Consultation
Welcome to Tier1 Optimal — book a time below.
Pick a slot that works for you. No credit card required for the free consultation with Brett.