For the already-fit · Optimization tier

Optimization protocols. For people who don't need to lose weight — they need the next layer.

If you already train, eat well, and sleep, the gap between where you are and where you could be isn't another habit. It's a layer of medicine most people never get access to: microdose GLP-1 for metabolic optimization, NAD+ for mitochondrial support, sermorelin for sleep and recovery, the Apex Panel for tracking what actually matters. Physician-prescribed, evidence-cited, built for the optimizer.

Last reviewed 2026-05-19 · References cited · Educational use only.

This is for you if

You're already training 3-5×/week and your nutrition is dialed
You want metabolic, cognitive, or recovery upgrades — not weight loss
You'd rather track biomarkers than guess
You want adjacent layers — peptides, NAD+, microdose — not just GLP-1 weight-loss doses
You're 35+ and noticing the recovery, energy, or sleep curves bending the wrong way

This is NOT for you if

You have 30+ lb to lose — start at our GLP-1 weight loss page instead
You haven't done the training and nutrition foundation yet — optimization stacks don't work without it
You're looking for diagnosis or treatment of a primary medical condition — that requires your own physician
You expect dramatic visible changes; optimization-tier protocols compound subtly over months

What matters most to you?

Drag the sliders to weight your goals. As you move them, we recompute which protocol best matches your priorities. Educational visualization — not a clinical recommendation.

Interactive · Goal weighting

Move the sliders. Watch the match update.

Each slider = how much that goal matters to you right now (0 = doesn't matter, 10 = top priority). The recommendation panel updates live.

Lose significant weight3

Stay lean while not gaining weight7

Preserve and build lean muscle8

Sleep deeper, recover faster7

Improve longevity biomarkers8

Energy, mood, quality of life8

Educational visualization. Match scores are computed from published clinical literature on the underlying molecules — they are estimates intended to help you weigh goals, not a clinical recommendation. Compounded preparations of semaglutide, tirzepatide, NAD+, sermorelin, and testosterone are not FDA-approved. Trial data referenced was generated with FDA-approved branded products. Individual results vary substantially based on baseline, adherence, training, nutrition, and labs. This tool is not a substitute for evaluation by a qualified healthcare provider.

How each protocol actually performs

Each protocol is strong on different axes. Click a protocol below to see its profile. Educational visualization based on published literature.

Values are educational estimates (0-10 scale) drawn from published trial data and clinical observation. Compounded preparations are not FDA-approved; trial data references FDA-approved branded products. Individual results vary.

The protocols

Each is physician-prescribed by U.S.-licensed providers in the Telegra MD network, dispensed through 503A compounding pharmacies (Strive, Boothwyn, Absolute), and shipped monthly.

Flagship · Bundled Best for committed optimizers

The High Performer Stack

$499/mo · all-inclusive

Tirzepatide + sermorelin, bundled. Burn fat (or maintain), protect muscle, sleep deeper, recover faster. The full stack at a single subscription price.

Explore the Stack →

Metabolic optimization For the already-lean

Microdose GLP-1

$199-299/mo · sema or tirz

Sub-clinical doses of semaglutide or tirzepatide for metabolic optimization and gentle appetite regulation. Not for weight loss — for the optimizer who wants cardiometabolic upside without dramatic appetite suppression.

Explore microdose →

GH-axis · Sleep + recovery For the 35+ recoverer

Sermorelin

$189/mo · or $499 / 3 mo

GHRH analog that restores endogenous growth hormone production — sleep architecture deepens, recovery improves, body composition slowly shifts. Pulsatile and physiologic, not supra-physiologic.

Explore sermorelin →

Mitochondrial · Longevity For the 40+ optimizer

NAD+ Therapy

$179/mo · or $489 / 3 mo

Cellular NAD+ drops ~50% by age 60. Subcutaneous NAD+ supports mitochondrial energy production, DNA repair, and sirtuin function. Gradual healthspan tool — not a stimulant.

Explore NAD+ →

Diagnostic · Foundation Start here if you've never tested

The Apex Panel

$599 · one-time, no subscription

160+ biomarkers covering hormones, cardiovascular, metabolic, inflammation, micronutrients, kidney, liver, and more. The single most useful starting point — you can't optimize what you don't measure.

Explore the Apex Panel →

Adjacent · Hormones For men with confirmed low T

TRT, or Enclomiphene

$129-199/mo · depending on protocol

If your Apex Panel shows total T below ~400 with symptoms, the hormone layer is upstream of any peptide or NAD+ work. Enclomiphene for endogenous restoration; TRT for direct replacement.

Explore TRT →

When does each protocol actually kick in?

Effects don't arrive on the same timeline. Visualized below as typical onset → plateau curves from clinical literature. Individual response varies.

Microdose GLP-1 Sermorelin NAD+ TRT High Performer Stack

Onset curves are educational approximations based on published trial timelines and observed clinical practice. Individual results vary substantially based on baseline biomarkers, training adherence, nutrition, and protocol cadence. Compounded preparations are not FDA-approved.

Build your stack

A real optimization stack is two or three protocols used purposefully, not eight. Common configurations our optimizer patients land on:

Common optimizer stacks

Each requires labs + physician review. Pricing shown is all-in monthly (or one-time where noted).

The Foundation

Just the Apex Panel. One-time deep biomarker read before adding anything else.

$599one-time

Feel + Function

Sermorelin nightly + NAD+ 2-3×/week. Sleep quality, recovery, baseline energy.

$349/mo · Longevity Stack

The Metabolic Edge

Microdose GLP-1 (sema or tirz) + Apex Panel quarterly. Visceral fat, insulin sensitivity, inflammation.

$199-299/mo + $599 panel

Full Optimization

The High Performer Stack + NAD+ + quarterly Apex Panel. The full top-end protocol.

$597/mo + labs

Hormone-First

For men with confirmed low T: Enclomiphene or TRT + Apex Panel. Hormones first, peptides later.

$129-199/mo + labs

Frequently asked questions

How is "optimization" different from weight loss or hormone therapy?

Weight loss is a destination problem — you have weight to lose and we get you there. Hormone therapy is a deficiency problem — your labs show you're low and we restore you to range. Optimization is a leverage problem — your baseline is fine, but you want the next layer of cardiometabolic, cognitive, and recovery performance that comes from precision tuning. Different goal, different protocol, different success measure.

Do I really need to test before starting any of this?

For most of these protocols, yes. Sermorelin, NAD+, and microdose GLP-1 can be started without comprehensive labs in some cases, but the response is significantly better — and the safety profile cleaner — when we know your baseline cortisol, sex hormones, lipid panel, glucose markers, inflammation, micronutrients, and thyroid status. The Apex Panel exists exactly for this.

How long until I notice changes?

Realistic expectations: TRT energy shifts inside 2-3 weeks; sleep quality from sermorelin by week 3-4; NAD+ biomarker changes show up at the next quarterly panel; microdose GLP-1 metabolic effects compound over months. See the onset timeline above for the typical curves.

Can I cycle on and off?

Depends on which protocol. Sermorelin and NAD+ are generally continuous-use; some practitioners cycle 5 days on / 2 off to preserve pulsatility. Microdose GLP-1 can be used continuously or in 3-6 month cycles. The Apex Panel is just a snapshot, not a protocol — re-run quarterly to track. Your provider helps tune cadence based on your labs and response.

Is this physician-prescribed or supplement-grade?

Every protocol on this page is prescribed by a U.S.-licensed physician in the Telegra MD network and dispensed by a 503A compounding pharmacy (Strive, Boothwyn, or Absolute) under USP <797> sterility standards. None of this is gray-market or supplement-grade. Compounded preparations are not FDA-approved; the underlying active ingredients are the same as the FDA-approved branded products where applicable.

What if my labs come back showing I shouldn't be on this?

That's the entire point of testing first. If your Apex Panel reveals a primary condition that needs medical management upstream of optimization, your physician routes you to the right protocol — which might be your primary care doctor, not an optimization stack. Optimization sits on top of a foundation; we won't sell you the top layer if the foundation isn't there.