Proudly Canadian
Tier1 OptimalTier1 Optimal

HRT · Ontario, Canada

Hormones, understood.

Crystal Troup, NP provides individualized hormone support for women navigating perimenopause, menopause, and beyond. Comprehensive labs, evidence-based protocols, and a clinician who listens.

Crystal Troup, NP — Lead Nurse Practitioner at Tier1 Optimal

Your dedicated clinician: Crystal Troup, NP

15+ years · Licensed in Ontario, Canada · Same clinician, every visit

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Crystal Troup, NP — clinician-led hormone optimization for women in Ontario

Lead Clinician

Crystal Troup, NP

15+ years · Ontario, Canada

Your Clinician

Crystal understands —
because she's a woman too.

Crystal knows what perimenopause, menopause, and hormonal shifts feel like — not just clinically, but personally. She has spent 15+ years helping women in Ontario navigate these changes with evidence-based care and protocols built around how they actually feel.

Comprehensive panels — estrogen, progesterone, testosterone, DHEA-S, TSH, free T3/T4, cortisol, metabolic markers. The full picture before any prescription.

I don't treat lab numbers. I treat people. The numbers tell me where to start — but your experience tells me if we're getting it right.
Crystal Troup, NP

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.

Pharmaceutical-grade

Estrogen, progesterone, testosterone.
Built for your biology.

Bioidentical formulations from licensed Canadian pharmacies — dosed at female physiological ranges, monitored quarterly.

Estrogen

EstroGel-style hormone gel pump
Estradot-style transdermal patch

Progesterone

Prometrium-style progesterone capsules

Testosterone

Low-dose testosterone injection vial
Compounded testosterone cream

Recognize Yourself?

Something feels off
— and no one is listening.

Hormonal shifts in your 30s, 40s, and 50s show up in dozens of small ways. Most are dismissed as stress.

Hot flashes & night sweats
Brain fog & forgetfulness
Persistent fatigue
Mood changes, anxiety, low mood
Weight gain you can't reverse
Low libido, vaginal dryness
Difficulty falling or staying asleep
Joint pain & stiffness
Hair thinning, skin changes
Concerns about bone density
I spent two years being told it was stress. One blood panel with Crystal and we had answers in a week.
Tier1 Optimal Patient

Self-Assessment

How many of these hit home?

Take the 2-minute assessment.

Patient Experience

I spent two years being told it was just stress.

Sarah was 43 when the symptoms started. Hot flashes that came out of nowhere. Night sweats that soaked through the sheets. Brain fog so thick she couldn't remember what she walked into a room for. She went from sleeping eight hours to waking up at 3 AM every night, unable to fall back asleep. She gained weight despite eating the same way she always had. Her mood was all over the place — anxious one hour, tearful the next.

She went to her family doctor three times. Each time she was told it was stress, that she was too young for menopause, and that she should try meditation and exercise. She was already exercising five days a week.

A colleague told her about Tier1 Optimal. Sarah enrolled, completed the intake, and booked with Crystal.

“Within the first five minutes, I felt like Crystal actually understood what I was going through. She didn't dismiss anything. She ordered a full panel — not just estrogen, but progesterone, testosterone, thyroid, cortisol, everything.”

Crystal reviewed the results, explained exactly what was happening, and built an individualized protocol. Within weeks, the night sweats started easing. By month two, Sarah was sleeping through the night for the first time in over a year. By month three, the brain fog had lifted and the hot flashes were rare.

Sarah sees Crystal quarterly. Her medication arrives at her door. Most of it is covered by her workplace insurance.

Every woman going through this deserves a Crystal. Do not wait two years like I did.

This is an individual patient experience. Results vary. All treatment is subject to clinical assessment and medical eligibility. Tier1 Optimal does not guarantee specific outcomes.

Women's hormone health has been underserved for too long. Too many women are told their symptoms are normal. They are not.

Crystal Troup, NP

Insurance Note: Many workplace insurance plans cover hormone replacement medications (estrogen, progesterone, and prescribed testosterone) with varying levels of coverage. Brett can help you verify your specific plan before you enroll.

★ The White Glove Difference

HRT protocols require coordination — lab timing, dosing adjustments, pharmacy follow-through, insurance navigation. We handle all of it. You just focus on your results.

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.

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.

Better together

Could your partner benefit too?

Hormonal imbalance affects both partners. If your husband or partner is experiencing fatigue, low drive, brain fog, or declining libido — Crystal can assess and treat them too. Ask about our Couples Plan and save 20%.

Learn About the Couples Plan

Treatment Options

Built for
your biology.

Crystal designs your protocol around your full hormonal picture — not just one number.

Option 01

Estrogen Therapy

Oral · Transdermal · Vaginal

Regulates mood, sleep, bone density, and cardiovascular function. Crystal selects the route and dose that fit your symptoms and risk profile.

Option 02

Progesterone

Micronized · Oral

Protects the uterine lining when estrogen is prescribed, supports sleep, and reduces anxiety. Bioidentical formulation.

Option 03

Testosterone (Low-Dose)

Precise monitoring

Supports energy, libido, motivation, and muscle. Dosed at female physiological ranges with regular bloodwork to keep you safely in zone.

Option 04

DHEA

Precursor support

Supports energy, mood, immune function, and downstream hormone production. Crystal monitors response and adjusts.

Option 05

Thyroid Support

Always tested

Hypothyroidism mimics menopause symptoms — and is frequently missed. Included in every panel and treated when indicated.

HRT FAQ

Common questions about women's hormone replacement.

HRT restores hormones — estrogen, progesterone, testosterone, DHEA, and thyroid support — that decline during perimenopause and menopause. Crystal designs individualized protocols based on comprehensive bloodwork, not a one-size-fits-all approach.

You deserve more

Than “just wait it out.”

Three months in, our HRT patients describe themselves as “a completely different person.” Same clinician — Crystal — every visit.

Not ready for an annual commitment? We also offer a flexible month-to-month plan — no contract, cancel anytime. See all plans →

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.

Choose Your Plan

Questions? Call Ava · 905-802-9603