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Choose your plan and book your initial consultation. Crystal Troup NP orders comprehensive bloodwork and builds your protocol from the results. Medication ships directly to your door. Follow-up appointments happen quarterly — same clinician, every visit.

Yes. Crystal Troup is a licensed Nurse Practitioner registered with the College of Nurses of Ontario with full prescribing authority. All medications are dispensed through licensed Canadian pharmacies.

Crystal Troup is a Nurse Practitioner with 15+ years of clinical experience specializing in hormone optimization, metabolic health, and women’s wellness. She is the lead and only clinician at Tier1 Optimal — every patient is treated by Crystal, every visit.

Yes. Tier1 Optimal operates as a licensed Ontario telehealth clinic. Crystal conducts all consultations virtually and can prescribe testosterone and other hormone therapies to patients anywhere in Ontario.

Often yes — up to 100% through many workplace benefits plans. Brett helps you understand your coverage before you commit. Your membership fee is separate from and not affected by insurance coverage.

Ozempic (semaglutide), Wegovy (high-dose semaglutide), Mounjaro/Zepbound (tirzepatide), and Contrave. All are Health Canada approved and dispensed through licensed Canadian pharmacies.

Yes. Crystal can prescribe Ozempic through telehealth in Ontario following a clinical assessment and bloodwork review.

Same molecule (semaglutide), different doses. Ozempic targets blood sugar; Wegovy is approved at a higher dose specifically for weight management. Crystal selects based on your goals and health history.

Yes — always. Crystal never prescribes without seeing your labs. Bloodwork requisitions are sent to your email; you complete them at a lab near you.

Every 90 days on the standard plan — four times per year. Tier1 Pro members have monthly follow-ups. Crystal reviews every result and adjusts your protocol accordingly.

Most patients book within days and complete bloodwork within a week. Medication typically ships 1–2 weeks after your initial consultation. No waitlists, no referrals.

Yes. Pharmaceutical-grade medication — including controlled substances like testosterone — ships directly to your door in discreet, unmarked packaging anywhere in Ontario.

Plans start from $125/month, or $3.77/day when paid annually. Visit our pricing page for details. Medication costs are separate and often covered by insurance.

Yes. If you have an existing prescription, Crystal can review your history and manage your care going forward. Contact Brett to discuss before booking.

Yes, when managed by a licensed clinician with proper bloodwork monitoring. The risk is unsupervised TRT — not TRT itself. Every Tier1 Optimal patient is monitored quarterly by Crystal with lab-data-driven protocol adjustments.

Yes — HRT for women is a core service. Crystal treats perimenopause, menopause, hormonal imbalances with estrogen, progesterone, low-dose testosterone, DHEA, and thyroid support.

Yes. Traumatic brain injuries — including concussions — can disrupt the hypothalamic-pituitary axis and suppress testosterone production. Crystal screens for this and has experience treating post-concussion hormonal disruption.

Environmental toxins, endocrine disruptors, chronic stress, poor sleep, sedentary lifestyles, and ultra-processed diets all suppress testosterone. Men today have measurably lower levels than men of the same age decades ago.

Frequently, yes. Low testosterone and hormonal imbalances present identically to clinical depression. The bloodwork takes five minutes and gives a definitive answer — which is why Crystal always runs it before doing anything else.

Hormone optimization is cumulative. A clinician who has seen your labs over multiple cycles understands your trajectory and response patterns in a way a rotating provider never can. Consistency is not a luxury — it is what makes the difference.

One clinician, every visit. White glove onboarding and coordination. Medication mailed to your door. 24/7 concierge. Transparent pricing. And a Clinic Manager who has lived this experience himself for nearly a decade.

Brett is the Clinic Manager and co-founder of Tier1 Optimal. He has been on TRT for nearly a decade and has experienced firsthand the difference proper clinical care makes. He handles onboarding, coordination, and day-to-day patient communication.

The Optimization Lab is Tier1 Optimal’s educational resource centre — articles, protocols, and guides on hormone health, weight loss, and wellness written by Crystal and Brett.

Ontario, Canada. All consultations are virtual. Medication ships to any address in Ontario. Crystal is licensed to prescribe province-wide.

Yes. Women’s HRT is a core service. Crystal treats perimenopause, menopause, and hormonal imbalances with estrogen, progesterone, low-dose testosterone, DHEA, and thyroid support.

Estradiol, progesterone, FSH, LH, total and free testosterone, DHEA-S, SHBG, full thyroid panel (TSH, T3, T4), metabolic panel, CBC, and additional markers as indicated.

Modern evidence strongly supports the safety of bioidentical HRT for appropriately selected patients. Crystal uses evidence-based protocols and monitors regularly. The risks of leaving hormonal imbalances untreated often exceed the risks of properly managed HRT.

No. Perimenopause is often the ideal time to start. Early intervention has the best long-term outcomes for bone density, cardiovascular health, and quality of life. Crystal assesses based on your labs and symptoms, not just your age.

Many HRT medications are covered by workplace benefits plans. Coverage depends on your specific plan. Brett helps you understand your coverage before you commit.