Tier 1 Health and Wellness Reviews: What Patients Say, What It Costs, and Who It's Right For

Last verified: November 2026 · By the TRT Provider Guide Editorial Team · Independent editorial research, not clinically reviewed

Last updated: November 3, 2026.

Disclosure: TRT Provider Guide may earn a commission if you use a qualifying Male Excel link on this page. We have no financial relationship with Tier 1 Health and Wellness. Compensation never changes what we verify or who we say a provider is wrong for. See How We Review TRT Providers.

Tier 1 Health and Wellness reviews are strongly positive. Tier 1 is an established, physician-owned hormone practice in Chattanooga, Tennessee, led by Dr. J. Keith Nichols, and Birdeye currently shows a 4.9-star rating across 288 reviews, mostly mirrored from Google. The catch is the fine print: Tier 1 does not post its annual enrollment fee, does not accept insurance, and its website contains older diagnostic language that goes beyond current Endocrine Society guidance.

So the star rating isn't the question that decides this. The real question is whether Tier 1's model fits your situation. That takes about five minutes to figure out, and this page walks you through it.

Tier 1 is a strong fit if you:

• have already been properly evaluated for low testosterone and want a cash-pay hormone practice
• want one doctor-led team you can contact during weekday business hours
• like the idea of a daily testosterone cream instead of injections
• are comfortable with an annual enrollment model and asking for the full contract before you pay

It's probably not for you if you:

• need insurance to pay for care
• want to see a complete price before you call anyone
• want a care model that clearly follows current specialty-society diagnostic guidance
• may want children in the near term and have not talked with a fertility-aware clinician
• need routine office support outside weekday business hours

TRT Provider Guide is the independent decision resource for testosterone replacement therapy — helping U.S. adults understand how low testosterone is evaluated, compare online and local care models and providers, and choose the next step that fits their health needs, fertility plans, budget, state, and care preferences, with every material claim verified and dated.

Tier 1 Health and Wellness at a glance

The right TRT provider is not the same for every person — it depends on whether low testosterone has been properly evaluated, your symptoms and health history, your fertility plans, your state, your insurance or cash-pay preference, your treatment-format preference, your budget, and whether online or in-person care is the better starting point. Some situations belong with primary care, urology, endocrinology, reproductive urology, or urgent or emergency care when the symptoms warrant it. If you are considering cash-pay online TRT, TRT Provider Guide's Find My TRT Path tool checks the featured Male Excel offer's age and state eligibility. It is not a clinical assessment and does not select specialist care or provide personalized appointment questions.

This page is educational information, not medical advice. If you have chest pain, trouble breathing, sudden weakness, or leg swelling and pain, call 911.

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What do patients say in Tier 1 Health and Wellness reviews?

Public reviews of Tier 1 Health and Wellness are strongly positive. Birdeye currently shows 4.9 stars from 288 reviews, with 287 attributed to Google and one to Birdeye. That is a useful patient-experience signal, but it cannot prove that a treatment is safe, effective, guideline-concordant, or right for you.

Here's every reputation signal we could verify well enough to publish, side by side.

What the strongest independent review signal tells us

The large Birdeye/Google review pool is a real strength for Tier 1. The review visible in Birdeye's current profile emphasizes personalized care and the role of Dr. Nichols and his team. That fits the clinic's positioning as a relationship-heavy practice rather than a low-touch prescription service.

But we did not independently code all 288 reviews, so we are not going to invent a detailed list of "common themes" or claim that no complaint pattern exists across the internet.

What reviews can't tell you

Reviews tell you how people felt about their care. They can't prove that a treatment is safe, that it works, that the diagnostic process follows current guidelines, or that your results will match someone else's. Tier 1's own testimonials describe major changes in energy, weight, and sex drive; those are selected stories, not evidence of typical results.

The review score is therefore one part of the decision, not the decision itself.

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Is Tier 1 Health and Wellness legit?

Yes. Tier 1 Health and Wellness is an established medical practice in Chattanooga. Tier 1 says it opened in 2010, BBB lists the company as incorporated in 2010 and accredited since 2019, and public NPI data list J. Keith Nichols, MD at the same practice address with Tennessee license number MD29413. An NPI record is not a live state-license verification, so current license status should be confirmed in Tennessee's official license lookup when that matters to your decision. Legit doesn't mean right for everyone, though.

Here's what we checked and what we found:

Who is Dr. Keith Nichols?

Dr. J. Keith Nichols is Tier 1's founder, CEO, and medical director. He earned his MD at the Medical College of Georgia and did his residency in physical medicine and rehabilitation (PM&R) at the University of Louisville. PM&R is a specialty focused on nerves, muscles, bones, and recovery. Before hormone therapy, his work centered on spine and sports medicine, and his bio lists team-physician work in Nashville pro sports.

His hormone training came through Worldlink Medical, the bioidentical hormone program associated with Dr. Neal Rouzier. Tier 1's site also says Dr. Nichols is on testosterone therapy himself, after a pre-treatment level of 254 ng/dL. That helps explain why so many patients describe him as someone who "gets it."

Does it matter that he isn't a urologist or endocrinologist?

A physician's original specialty does not by itself answer whether TRT care is appropriate. Testosterone is a Schedule III controlled substance, so the prescriber must have the required state prescribing authority and DEA registration, and the clinical work still has to answer why testosterone is low. Pituitary or testicular disease, certain medicines, sleep disorders, obesity, and other conditions may need their own evaluation.

So ask Tier 1 directly: "How do you look for the cause of low testosterone, and when do you refer patients to a specialist?" A good answer is specific.

Who else is on the team?

Tier 1's team page lists:

• Angela Nichols, RN — co-founder, 25+ years as a nurse
• Jill Hammond — operations manager
• April Jones — clinical coordinator
• Betty Smith — billing specialist
• Elaine Adler — "Master Compounder, Dispensary Director"

That last title is worth asking about, but it does not by itself prove that Tier 1 operates an on-site licensed pharmacy or compounds medication in-house. We come back to the pharmacy question in the treatment section.

Does this sound like the kind of practice you've been looking for? The smartest first step costs nothing: ask Tier 1 for its contract before you pay anything. Its FAQ says it will send one for review.

Contact Tier 1 to request its contract and current pricing →

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How much does Tier 1 Health and Wellness cost?

Tier 1 charges an annual enrollment fee that it does not publish online, and it does not accept insurance. Its FAQ says the fee covers office or telemedicine visits, unlimited calls and portal access, plus Dr. Nichols' monitoring, adjustments, prescribing, and lab ordering. Tier 1 says it will send its contract on request, and that contract is the right place to confirm the current price and exclusions.

This is the question most people actually came here with. So here's exactly what Tier 1 says, and what it leaves out.

What Tier 1 says the annual fee covers

According to Tier 1's FAQ, the enrollment fee covers:

• all office or telemedicine visits
• unlimited phone calls
• unlimited patient-portal messaging
• Dr. Nichols' monitoring, dose adjustments, and prescribing
• ordering your lab work
• staff availability Monday–Friday, 8 a.m.–5 p.m. Eastern

What the public FAQ does not prove is included

One detail is easy to miss. "Ordering lab work" is not the same as "paying for lab work." Tier 1's public pages reviewed for this audit do not establish that the annual fee pays for these:

• your blood tests
• the physical exam from your local provider
• your medication
• shipping

Do not count any of these as included until the current contract or a written Tier 1 quote says so.

Insurance, payment plans, and discounts

• Insurance: Not accepted, per Tier 1's About page.
• Payment: All major credit cards. Installment payment plans are available (call for details).
• Discounts: Tier 1 offers a "generous discount" for military, police, and firefighters.

If Tier 1 still requires outside physical-exam or laboratory services, whether your own insurance will cover those services depends on your plan and the billing provider. Check with your insurer before assuming coverage.

What a first year could cost: Tier 1 vs. two online alternatives

We checked the providers' current public pricing on November 3, 2026. Tier 1's complete first-year cost still cannot be calculated from public information. Male Excel publishes enough to calculate a known starting subtotal before shipping and any separately charged testing; Hone's current Plus plan publishes membership and intake testing, but its injectable testosterone price is listed per vial rather than as a guaranteed monthly medication cost.

Two notes on reading this table. First, starting medication prices are not quotes. Your actual prescription and refill pattern can change the total. Second, a low advertised medication price is not the full care cost; membership, testing, shipping, and other required fees matter.

The one tradeoff to understand before you call

Here's the honest truth about Tier 1's pricing. Tier 1 does not post its annual enrollment fee. If seeing known starting costs before you talk to anyone is your top priority, an online provider with public pricing may be easier to compare.

But Tier 1's annual model has a real potential upside for the patient who values access. Its FAQ says office or telemedicine visits, unlimited phone calls, portal access, monitoring, adjustments, and prescribing are covered by the enrollment fee. The catch is that you still need the current contract to know the dollar amount, exclusions, cancellation terms, and whether laboratory or medication charges sit outside that fee.

Does Tier 1 still sound like your kind of practice? Ask for the contract and a written list of every required first-year charge before you pay.

Contact Tier 1 to request its contract and current pricing →

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How does Tier 1's program work, step by step?

Tier 1's published intake materials describe a consultation, a physical exam and lab work, a telemedicine visit with Dr. Nichols for male TRT care, annual enrollment, a personalized plan, and follow-up. Because some of those details come from an older TRT page and an older annual physical form, confirm the current intake steps before assuming you will not need an in-person visit.

An older Tier 1 TRT page lists these six steps:

1. Request a consultation by phone or the online form.
2. Get a full physical exam from a healthcare provider near you, plus lab work at a lab near you.
3. Meet with Dr. Nichols by telemedicine for the male TRT pathway described on that page.
4. Enroll in the annual program.
5. Receive a personalized treatment plan based on your symptoms and labs.
6. Follow up so Tier 1 can monitor progress and adjust treatment.

The patient portal

Current patients use an online portal to check lab results, message staff, request refills, and manage appointments.

Office hours and response times

• Hours: Monday–Friday, 8 a.m.–5 p.m. Eastern. Closed for lunch 12–1. Closed weekends.
• Email: Tier 1 says replies can take 24–48 hours when it's busy, and recommends calling for a faster answer.

If you live on the West Coast, those posted office hours are 5 a.m.–2 p.m. Pacific. The site lists the office as closed on weekends; it does not publish an after-hours support promise on the pages we reviewed.

Age requirements

Tier 1's current home page says its programs are focused on men and women over 40. An older TRT page says it offers TRT to men 30 and older. Because the TRT page is explicitly labeled "OLD," confirm the clinic's current age and intake policy rather than treating that older statement as a current eligibility rule.

Can Tier 1 treat you in your state?

Tier 1's website says it offers "telemedicine worldwide." That's not the same as being able to prescribe testosterone wherever you live.

Testosterone is a Schedule III controlled substance. That means federal law treats it as a drug with abuse potential, and it always needs a valid prescription. Two rules apply:

• State authority. The prescriber must be authorized under the law of the state where the patient is located. Depending on the state, that may require a full license, telemedicine registration, compact privilege, or another lawful basis.
• Federal telehealth rules. DEA and HHS have extended the temporary federal flexibilities that can allow DEA-registered practitioners to prescribe Schedule II–V controlled medications after qualifying telemedicine encounters without a prior in-person medical evaluation. The current extension runs through December 31, 2026, and prescriptions still must comply with federal and state law.

Ask Tier 1 two questions:

1. "Is the clinician who would prescribe for me currently authorized to treat and prescribe testosterone to a patient located in my state?"
2. "If federal telehealth rules change in 2027, how will my prescriptions continue?"

You can also confirm any doctor's license yourself through your state medical board's online lookup.

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What testosterone treatments does Tier 1 offer?

Tier 1's 2025 treatment guide says its preferred method for men is a compounded testosterone cream applied daily to the scrotum. It also offers testosterone injections and says it does not use or recommend pellets. Compounded drugs are not FDA-approved, so ask exactly what product you would receive, whether an FDA-approved option is available, and which licensed pharmacy would dispense it.

Tier 1's favorite: compounded scrotal cream

Dr. Nichols is known for this method, called trans-scrotal application (the cream goes on the skin of the scrotum). Scrotal skin is thin, so it absorbs testosterone well. Tier 1's blog calls the cream its "preferred method" and says patients can switch to injections if the cream doesn't suit them.

The cream is compounded. That means a pharmacy mixes it for an individual prescription instead of a drug company making it at scale. Here's why that matters:

• Compounded products are not FDA-approved. The FDA hasn't reviewed them for safety, effectiveness, or quality the way it reviews brand-name or generic drugs.
• Potency and quality can vary. The AUA guideline notes considerable variation in potency and quality among compounded testosterone preparations and recommends commercially manufactured testosterone when possible.
• Guidelines prefer commercial products. The American Urological Association (AUA) recommends commercially made testosterone over compounded testosterone "when possible."

Tier 1's blog describes its cream as lower-risk than injections for some side effects. We haven't seen strong evidence for that claim, so we don't repeat it as fact. If cream appeals to you, ask Tier 1 what evidence its claim is based on.

Injections

Tier 1 offers injectable testosterone but says it isn't its first choice for men. FDA-approved injectable testosterone products are available. Ask whether the specific injection Tier 1 would prescribe is an FDA-approved product or a compounded preparation.

Who makes your medication?

This is the most important question on this page that Tier 1's website doesn't answer. Tier 1's team page lists a Master Compounder and Dispensary Director. Her listed background is 32+ years in compounding and retail pharmacy, and she is a nationally certified pharmacy technician. That title does not establish that Tier 1 operates a licensed pharmacy or prepares your prescription in-house.

Before paying, you deserve to know:

• Which licensed pharmacy compounds your prescription
• Whether that pharmacy's license covers your state
• Whether your medication is FDA-approved or compounded

Beyond testosterone

Tier 1 describes its approach as "hormone optimization," not just testosterone replacement. Its site says it may also treat DHEA, thyroid, melatonin, pregnenolone, estrogen, and progesterone levels. If that's offered to you, ask what each one is for, what it costs, and how it's monitored.

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How does Tier 1's approach compare with medical guidelines?

Tier 1's website contains a real tension that matters. An older TRT page says the clinic may treat symptoms of hypogonadism regardless of total testosterone level, while a newer 2025 Tier 1 article says a clinical diagnosis typically includes symptoms plus blood tests showing low total and/or free testosterone. Current Endocrine Society guidance requires symptoms or signs and consistently low, accurately measured testosterone, confirmed with at least two early-morning fasting tests.

This is the most useful thing we can give you, so we built a side-by-side audit. The Tier 1 column reflects what its public pages say; when an older page conflicts with newer material, we say so instead of pretending we know which rule the clinic uses today.

A few quick definitions first:

• Hypogonadism: A condition in which the testes do not produce enough testosterone, sometimes because of a problem in the testes themselves and sometimes because of the pituitary or hypothalamus.
• Total testosterone: All the testosterone measured in your blood.
• Free testosterone: The small fraction not tightly bound to proteins.
• Hematocrit: The percentage of your blood made up of red blood cells. Testosterone therapy can raise it.
• PSA (prostate-specific antigen): A blood test used as part of prostate-risk assessment and monitoring in selected men.

Here's our editorial take. Tier 1 is unusually open about some places where its philosophy differs from mainstream specialty guidance. That is useful. The bigger issue is that its own website now contains both older, more aggressive diagnostic language and newer language that sounds closer to standard diagnosis. Our job isn't to guess which one governs current care; it's to make sure you ask before you sign.

"My doctor said my levels are normal." Now what?

This is where a lot of people become interested in clinics like Tier 1. You feel tired, your drive is gone, and your doctor says the numbers are fine. That's frustrating, and Tier 1's message speaks directly to that feeling.

Before you jump to any clinic, make sure the diagnosis itself is solid:

1. Confirm testosterone with appropriate early-morning testing. Current Endocrine Society guidance calls for at least two early-morning fasting testosterone tests when diagnosing hypogonadism.
2. Ask whether free testosterone is appropriate in your case. It can help when total testosterone is borderline or binding proteins may distort the total result. Read more about total vs. free testosterone and SHBG.
3. Look for the cause. Pituitary or testicular disease, sleep problems, obesity, certain medications, and other conditions can affect testosterone or cause similar symptoms.

Then you'll know whether you're choosing between treatment options or still figuring out the diagnosis. Those are different decisions. More here: what testosterone level qualifies for TRT and why two low tests matter.

Still not sure if you need a clinic or a workup first? Discuss that question with a qualified clinician. If you are considering cash-pay online TRT, TRT Provider Guide's Find My TRT Path tool checks the featured Male Excel offer's age and state eligibility. It's educational and doesn't diagnose anything.

Check the featured online TRT offer's age and state eligibility →

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What if you want kids someday?

If you may want children in the near term, talk to a fertility-aware clinician — often a reproductive urologist — before starting testosterone with any clinic. Testosterone from outside the body can lower sperm production — Tier 1's own blog says so. The Endocrine Society recommends against starting testosterone in men planning fertility soon.

Here's the simple version of why. Your testes make sperm using testosterone produced inside them. Your brain sends two signals to keep that going: LH (luteinizing hormone) and FSH (follicle-stimulating hormone). When you take testosterone from outside, your brain senses plenty of it and turns those signals down. Sperm production (spermatogenesis) can drop as a result.

Tier 1's blog mentions hCG or Clomid (clomiphene) as alternatives or add-ons. Keep two things straight:

• These are not TRT. They work differently, by prompting your own body to make more testosterone.
• No treatment guarantees fertility. Clomiphene is FDA-approved for women's fertility. Using it in men is off-label. Results vary.

If kids are part of your plan, start here: hCG with TRT and hCG vs. Clomid. Then see a reproductive urologist before you enroll anywhere.

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Is Tier 1 Health and Wellness right for you?

Tier 1 may fit an adult man who has already been properly evaluated for low testosterone, wants a doctor-led cash-pay practice with weekday phone and portal access, and likes its cream-first approach. It's a weaker fit if you need insurance, posted all-in pricing, month-to-month billing, clearly guideline-concordant diagnostic criteria, or fertility-focused care.

Find yourself in this table:

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10 questions to ask Tier 1 before you sign

Before you enroll, ask Tier 1 for its written contract. Then confirm the annual fee, what it excludes, cancellation terms, your state's licensing, which pharmacy makes your medication, and whether it's FDA-approved. Also ask how Tier 1 confirms a diagnosis and handles high red blood cell counts. Get the key answers in writing.

Screenshot this list or print it. It turns a sales call into a fact-finding call.

1. What is the annual enrollment fee, and what isn't included? (Labs, local physical, medication, shipping.)
2. Can I cancel during the year? Is any of the fee refundable?
3. Does the contract renew automatically?
4. Is the clinician who would prescribe for me authorized to treat a patient located in my state right now?
5. Which pharmacy makes my prescription, and is that pharmacy licensed for my state?
6. Will my medication be FDA-approved or compounded?
7. Do you confirm low testosterone with two early-morning tests before starting?
8. What do you do if my hematocrit rises too high?
9. How often do you check my testosterone, hematocrit, PSA, and blood pressure?
10. I may want children. How would you handle that — or should I see a specialist first?

Bonus question if you live outside Tennessee: "If federal telehealth rules change in 2027, how will my refills continue?"

Got your list ready? Reach Tier 1 by phone at (423) 417-1700 during business hours (fastest), or use its contact form.

Send Tier 1 your questions and request the contract →

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Tier 1 Health and Wellness alternatives

If Tier 1's annual enrollment model or clinical approach doesn't fit, three care routes cover most readers. Male Excel suits people who want published starting prices and no contract. Hone Health suits people who want a telehealth pathway with a separate confirmatory test before TRT when indicated. A local urologist, endocrinologist, or primary care clinician may fit better when insurance, a cause workup, or complex medical history matters more than convenience.

Provider prices checked November 3, 2026. Starting prices are not individual quotes and may change with prescription, dosage, testing pathway, or provider terms.

Male Excel: best for published starting prices with no contract

Male Excel is the closest commercial alternative on this page if Tier 1's cash-pay model appeals to you but the unpublished annual fee does not.

• What you pay: a required $99 online medical consultation, a $99/month Medical Membership, and medication billed separately.
• Formats: compounded testosterone injections start at $120/month; compounded testosterone cream starts at $132/month.
• Commitment: Male Excel says there is no contract and you can cancel anytime.

Easiest-to-miss limitation: Male Excel's listed testosterone packages pair testosterone with thyroid medication, and its site says its compounded medications are not FDA-approved. Its footer also says that federal or state law may require an in-person exam.

Not for you if you need insurance or want a conventional specialist-led diagnostic pathway.

If published starting prices and no contract fit what you're looking for:

Check Male Excel's current plans and state availability →

Hone Health: useful for comparison if confirmatory testing matters

Hone's current Plus pathway is useful as a non-Tier-1 comparison because it publishes the intake testing steps and requires a confirmatory test when TRT is being considered.

• Initial test: $45 on the current Plus-plan help page.
• Confirmatory test for TRT: $45 at a lab or $80 at home.
• Membership: $135/month for Plus.
• Medication: testosterone cypionate starts at $28/vial; compounded cream starts at $60/month.
• Follow-up: Hone says follow-up labs and consultations are included in the Plus membership.

Easiest-to-miss limitation: medication is billed separately, and the per-vial injection price cannot be treated as a guaranteed monthly medication total.

If Hone interests you, verify its current pricing and state availability directly before enrolling. No commercial Hone CTA is included on this page; see the source links below for its published plan details.

A local urologist, endocrinologist, or primary care clinician: best when insurance or diagnostic complexity matters

If insurance coverage, fertility, a pituitary or testicular cause, or another complex medical issue is your priority, local care may be the better starting point. Coverage rules differ by plan, so check the policy rather than assuming TRT is covered:

• Does Aetna cover TRT?
• Does Blue Cross Blue Shield cover TRT?
• Does Medicare cover TRT?

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What we actually verified

We reviewed Tier 1's own website, public business and provider records, third-party review platforms, and current guidance from the FDA, AUA, Endocrine Society, and DEA. We separated four things: facts we could corroborate, claims Tier 1 makes about itself, patient-review signals, and our own editorial judgment. No one on our team has been a Tier 1 patient.

Our full process is explained in How We Review TRT Providers. We don't assign star scores, and listing a provider isn't an endorsement.

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Tier 1 Health and Wellness FAQ

How much does Tier 1 Health and Wellness cost?

Tier 1 charges an annual enrollment fee that it doesn't publish online. Its FAQ says the fee covers visits, unlimited calls and portal access, plus Dr. Nichols' monitoring, adjustments, prescribing, and lab ordering. The public pages do not establish the complete cost of labs, medication, outside physical-exam services, or shipping, so request the current written contract and a complete first-year quote.

Does Tier 1 Health and Wellness take insurance?

No. Tier 1 says it does not accept insurance. It accepts major credit cards and offers installment payment plans. Your local physical and lab work may still be billable to your own insurance, depending on your plan.

Is Tier 1 Health and Wellness legit?

Yes. Tier 1 is an established Chattanooga medical practice. BBB lists it as incorporated in 2010 and accredited since August 2019 with an A+ rating, and public NPI data list J. Keith Nichols, MD at the same address. An NPI record is not a live medical-license check, so use the Tennessee official lookup if you need current license status.

Who is Dr. Keith Nichols?

Dr. J. Keith Nichols is Tier 1's founder and medical director. He trained in physical medicine and rehabilitation at the University of Louisville after earning his MD from the Medical College of Georgia. He completed bioidentical hormone training through Worldlink Medical and hosts the Tier 1 Health and Wellness Podcast.

Where is Tier 1 Health and Wellness located?

2700 Oak St, Chattanooga, TN 37404. Phone: (423) 417-1700. Some older online listings show a former Northgate Park Lane address.

Do I have to go to Chattanooga?

Tier 1 advertises telemedicine and its published intake materials describe outside physical-exam and laboratory steps, but some of those materials are older. Confirm the current intake process and make sure the treating clinician is authorized to care for a patient located in your state.

What is trans-scrotal testosterone cream?

It's a testosterone cream applied to scrotal skin. Tier 1's 2025 guide says the cream it prefers is compounded. Compounded drugs are not FDA-approved before marketing, and AUA guidance notes that potency and quality can vary among compounded testosterone preparations.

Does Tier 1 offer testosterone pellets?

No. Tier 1's blog says it does not use or recommend testosterone pellets.

Will Tier 1 treat me if my testosterone is "normal"?

An older Tier 1 TRT page says it may treat symptoms regardless of total testosterone level, but a newer 2025 Tier 1 article says diagnosis typically includes symptoms plus low total and/or free testosterone. Because the site's wording conflicts, ask what standard Tier 1 uses now. The Endocrine Society says symptoms alone are not diagnostic and recommends at least two early-morning fasting tests showing consistently low testosterone.

Can I do TRT with Tier 1 if I want children?

Talk to a reproductive urologist first. Testosterone from outside the body can lower sperm production, and Tier 1's own blog acknowledges this. No treatment guarantees fertility.

What are Tier 1's office hours?

Monday through Friday, 8 a.m. to 5 p.m. Eastern, with a lunch break from noon to 1 p.m. It's closed on weekends.

What happens to telehealth testosterone prescriptions after 2026?

Federal rules that let doctors prescribe controlled medicines like testosterone by telehealth without a prior in-person visit run through December 31, 2026. Ask any telehealth provider, including Tier 1, how your refills would continue if those rules change.

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The bottom line on Tier 1 Health and Wellness

Tier 1 Health and Wellness has a strong public review signal and a long operating history. Its annual model is built around access to the same doctor-led team rather than pay-per-visit care.

But a great reputation isn't a great fit by default. Tier 1 uses an annual enrollment model without posting the fee, prefers a compounded cream, and its website contains older diagnostic language that conflicts with both its newer material and current Endocrine Society guidance.

If you've already had a proper low-testosterone evaluation and you value a close, cash-pay relationship with one practice, call Tier 1 with the 10 questions above and get the contract in writing. If the cost, diagnostic philosophy, fertility plan, state access, or treatment format doesn't fit, use the alternatives above to choose a better care route.

Considering a cash-pay online TRT option? Use our free Find My TRT Path tool to check the featured Male Excel offer's age and state eligibility.

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Sources

1. Tier 1 Health and Wellness — Home. https://tier1hw.com/ (accessed Nov. 3, 2026)
2. Tier 1 Health and Wellness — About Us. https://tier1hw.com/about-us/ (accessed Nov. 3, 2026)
3. Tier 1 Health and Wellness — FAQs. https://tier1hw.com/faqs/ (accessed Nov. 3, 2026)
4. Tier 1 Health and Wellness — Testosterone Replacement Therapy (older page, labeled "OLD"). https://tier1hw.com/our-services/testosterone-replacement-therapy-old/ (accessed Nov. 3, 2026)
5. Tier 1 Health and Wellness — How TRT Works: Injections vs. Creams vs. Gels vs. Pellets. https://tier1hw.com/how-trt-works-injections-vs-gels-vs-pellets-including-all-esters/ (accessed Nov. 3, 2026)
6. Tier 1 Health and Wellness — Low Testosterone vs. Normal Aging. https://tier1hw.com/low-testosterone-vs-normal-aging-how-to-tell-the-difference/ (accessed Nov. 3, 2026)
7. Tier 1 Health and Wellness — Keith Nichols, MD. https://tier1hw.com/personnel/keith-nichols/ (accessed Nov. 3, 2026)
8. Tier 1 Health and Wellness — Our Team. https://tier1hw.com/our-team/ (accessed Nov. 3, 2026)
9. Tier 1 Health and Wellness — Patient Portal. https://tier1hw.com/patient-portal/ (accessed Nov. 3, 2026)
10. Tier 1 Health and Wellness — Contact Us. https://tier1hw.com/contact-us/ (accessed Nov. 3, 2026)
11. Tier 1 Health and Wellness — Annual Male Physical Examination Form. https://tier1hw.com/wp-content/uploads/2023/10/Annual-Male-Physical.pdf (form revised Apr. 18, 2019; accessed Nov. 3, 2026)
12. Better Business Bureau — Tier 1 Health & Wellness. https://www.bbb.org/us/tn/chattanooga/profile/hormone-replacement-therapy/tier-1-health-wellness-0483-40118571 (accessed Nov. 3, 2026)
13. Birdeye — Tier 1 Health and Wellness review profile. https://reviews.birdeye.com/tier-1-health-and-wellness-bio-identical-hormone-therapy-dr-166859295256089 (accessed Nov. 3, 2026)
14. NPI 1467452771 public provider data (used for identity/taxonomy/license-number fields only; not as proof of current licensure). https://npiprofile.com/npi/1467452771 (accessed Nov. 3, 2026)
15. U.S. Food and Drug Administration — Testosterone Information (updated 2026). https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/testosterone-information
16. U.S. Food and Drug Administration — FDA issues class-wide labeling changes for testosterone products (Feb. 28, 2025). https://www.fda.gov/drugs/drug-alerts-and-statements/fda-issues-class-wide-labeling-changes-testosterone-products
17. Endocrine Society — Statement on Testosterone Replacement Therapy (July 16, 2026). https://www.endocrine.org/news-and-advocacy/news-room/2026/statement-on-testosterone%20replacement-therapy
18. Endocrine Society — Testosterone Therapy for Hypogonadism Guideline Resources. https://www.endocrine.org/clinical-practice-guidelines/testosterone-therapy
19. American Urological Association — Evaluation and Management of Testosterone Deficiency Guideline. https://www.auanet.org/guidelines-and-quality/guidelines/testosterone-deficiency-guideline
20. U.S. Drug Enforcement Administration — DEA Extends Telemedicine Flexibilities to Ensure Continued Access to Care (Dec. 31, 2025; extension through Dec. 31, 2026). https://www.dea.gov/press-releases/2025/12/31/dea-extends-telemedicine-flexibilities-ensure-continued-access-care
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