Frequently Asked Questions

Osteoporosis is a condition in which bones become weak and brittle. The body constantly absorbs and replaces bone tissue. This is called bone remodelling. If you suffer from osteoporosis, the new bone creation doesn’t keep up with old bone removal. Most people have no symptoms until they have a bone fracture.

In the USA approximately 50% of women and 25% of men over the age of 50 have Osteoporosis.

Osteopenia is a condition characterized by lower-than-normal bone density, but not severe enough to be classified as osteoporosis. It represents a midway point between healthy bones and osteoporosis. It’s not a disease, but rather a sign of potentially declining bone health that can increase the risk of fractures and could develop into osteoporosis if left unaddressed.

Common calcium supplements are usually extractions from limestone (known as Calcium Carbonate). Studies have shown that our bodies struggle to absorb this form of calcium, often only managing to absorb 2%.  It is like chalk.

Cal20 is uniquely designed to be 100% bioavailable, which means it naturally integrates into your body chemistry with the least amount of side effects.

Each Cal20 tablet contains:

  • Phosphorus: 135mg
  • Magnesium: 42.5mg
  • Potassium: 10mg
  • Magnesium from magnesium oxide: 30mg
  • Calcium: 275mg
  • Vitamin D3: 200iu
  • Soy Isoflavones: 30mg
  • Probiotics: 8 Million CFU (Lactobacillus sporogenes)
Cal20 is free from fillers, heavy metals and lead.
  • They increase the absorption of Calcium
  • They increase the absorption of Vitamin D3 critical for calcium absorption
  • They help with bone mineralization which is a biological process by which minerals, primarily calcium and phosphorus are deposited and accumulated within bone tissue. It is a crucial aspect of bone development and maintenance and contributes to the strength, rigidity and overall structure of the skeletal system.
  • They help render the medium acidic in small intestine to facilitate absorption of minerals by making them more soluble.
  • Probiotics produce phytases to neutralize the phytic acid in the gut and thus help in retaining minerals in their soluble form for better absorption.
  • They provide lactase enzymes to neutralize lactose intolerance in sensitive patients.
  • They liberate carboxylic acids (SCFAs) like butyrate, propionate and acetate in the large intestine, which enhances the mineral uptake by the colonocytes and thereby further enhance the mineral bioabsorption.
  • Cal20 is the only calcium supplement that contains Probiotics.
  • The Calcium in Cal20 is in micronized form, which in itself is a significant factor for bioavailability. The particle size is less than 40 microns which is excellent for bio-absorption.
  • The phosphorus balance in Cal20 is 2:1, the same found in human bones. This 2:1 ratio also improves the absorption of calcium.
  • It is estimated that the absorption of calcium and minerals in Cal20 is near 100%. The body only absorbs about 2% of common calcium like calcium carbonate and calcium citrate.
  • It is a natural calcium derived from cows’ milk, in its ionic form. (An ion is a mineral or element that has a positive or negative charge. This unstable ionic state allows the element to bond readily with water, making it possible for the body to absorb it.)
  • Since there is almost 100% bio-absorption and there is no presence of salt, Cal20 will not cause gastric irritation nor constipation.
  • Cal20 assists bone development and increases bone mass in children and adolescents. In adults, it can play a major role in providing relief of poor bone health symptoms and prevents further decline of bone health.
  • Cal20 is a natural milk calcium that can be used safely by vegetarians.
  • Cal20 is an excellent supplement for anyone struggling to consume the RDA for calcium. 

Unlike traditional calcium supplements currently on the market, such as calcium carbonate and citrate that are not highly bioavailable, Cal20 has shown no side effects in all the clinical trials conducted worldwide. To date there have been no reports of any adverse side effects, in the near 10 years it has been available to purchase. Cal20 is also free from fillers, heavy metals and lead.

If you have a family history of osteoporosis, or if you have risk factors such as being female, postmenopausal, over the age of 65, are vegan, have a history of an eating disorders, have a small body frame, or have had chemotherapy, you should consider taking action against possible osteoporosis sooner rather than later. The best time to prevent a life-threatening condition like osteoporosis is yesterday. The second best time is today. Have a bone density scan as soon as possible.

Yes menopause does increase the risk of developing osteoporosis, one of the main reasons is related to the female hormone estrogen, which plays an important role in maintaining bone strength. Estrogen levels drop around the time of menopause, which occurs on average around the age of 50 years but perimenopause can begin in a woman’s late 30’s, resulting in increased bone loss. If your peak bone mass before menopause is less than ideal, any bone loss that occurs around menopause may result in osteoporosis.

Research suggests shows that about one in two women over the age of 60 years will experience at least one fracture due to osteoporosis in her later years.

Yes, certain types of chemotherapy can increase the risk of osteoporosis. While not all chemotherapy drugs have this effect, some commonly used ones, such as corticosteroids, aromatase inhibitors, and certain types of hormone therapies, have been associated with an increased risk of osteoporosis.

Chemotherapy-induced bone loss can occur due to several mechanisms. Corticosteroids, for example, can lead to bone loss by inhibiting bone formation and increasing bone resorption.

Aromatase inhibitors, commonly used in breast cancer treatment, can reduce estrogen levels in the body, which can accelerate bone loss. Additionally, some hormone therapies used in the treatment of prostate cancer can also contribute to bone loss.

It’s important to note that the risk of osteoporosis and bone loss can vary depending on the specific chemotherapy drugs used, the dosage, and the duration of treatment. Not all cancer patients undergoing chemotherapy will develop osteoporosis, but the risk should be assessed on an individual basis.

If you are receiving chemotherapy and are concerned about the potential impact on your bone health, it is advisable to discuss this with your healthcare provider. They can evaluate your risk factors, conduct bone density tests if necessary, and recommend appropriate preventive measures or treatments to help maintain bone health during and after chemotherapy.

Osteoporosis is best diagnosed using a specialised X-ray technique called dual energy X-ray absorptiometry (DXA or DEXA). A DXA scan measures bone density (or thickness), usually at the lower spine and at the upper part of the hip but can include the neck region. The results of a DXA scan are reported as a Z-score and a T-score. The Z-score compares your bone mass with what would be expected for a person of your age. The T-score shows how much your bone mass varies from that of a young person with peak bone mass.

T-scores are interpreted as follows:

  • 0 is the average bone density of a healthy 30 year old of the same sex.
  • between +1 and -1 indicates normal bone density.
  • between -1 and -2.5 indicates osteopenia – this means some bone density loss, but not enough to be called osteoporosis. Even though the bones are less dense, the risk of fracture with minimal trauma is low.
  • less than -2.5 indicates osteoporosis – substantial loss of bone density means a much higher risk of having a fracture with minimal trauma.

Z-scores are calculated in terms of standard deviations from a relative average.

Z-scores are particularly helpful when evaluating bone density in children, teens, women who are still menstruating, and men under age 50. These groups are expected to be in their peak bone-building years, and so a comparison with their age group (Z-score) can provide more meaningful information than a comparison with T-Score. A Z-score of 0 signifies that the individual’s bone density is exactly average for their demographic group. Here is a chart summarizing the results of different Z-scores:
Z-Score Interpretation
-3 or less Significantly below average, far lower than the average.
-2 Bone density is two standard deviations beneath the average.
-1 Bone density is one standard deviation beneath the average.
0 Bone density is exactly the average for the demographic group.
+1 Bone density is one standard deviation above the average.
+2 Bone density is two standard deviations above the average.
+3 or more Significantly above average, far exceeding the mean.
A Z-score of -2.0 or lower would suggest a bone density significantly below what’s expected for the individual’s age, sex, weight, and ethnic or racial origin, and this could indicate a potential issue with bone health such as osteoporosis.

A type of arthritis that occurs when the flexible tissue at the ends of bones wears down. The wearing down of the protective tissue at the ends of bones (cartilage) occurs gradually and worsens over time. Joint pain in the hands, neck, lower back, knees or hips are the most common symptom.

We use a special patented technique called an ultra-filtration process, which gives a high yield of absorbable elemental calcium from cow’s milk in a mineral complex.

Elemental calcium simply refers to the pure calcium content without any additional compounds. It represents the actual amount of calcium available for absorption and utilization by the body. When calcium is in its elemental form, it is already in a state that can be readily absorbed by the body. It does not require further breakdown and can easily cross into cells. There is 275mg of elemental calcium in each Cal20 tablet.

Bioavailability refers to the portion of a substance that is absorbed and used by the body. When speaking about dietary supplements, bioavailable means that the nutrients in the tablet can be absorbed into the body and have an active effect.

  1. Cal20 is a natural calcium derived from cows milk which is highly bioavailable since the calcium is in its pure elemental form. When calcium is in its elemental form, it is already in a state that can be readily absorbed by the body. It does not require further breakdown and can easily cross into cells. This leads to higher absorption rates compared to other forms of calcium.
  2. Calcium salts, such as calcium carbonate or calcium citrate, contain varying amounts of elemental calcium. When you see a calcium supplement label indicating the amount of calcium present, it is referring to the elemental calcium content. For example, if a supplement contains 500 mg of calcium carbonate, it typically provides 200 mg of elemental calcium. The rest of the weight comes from other compounds and impurities that are bound to the calcium. The body has to breakdown and process these compounds before it can access the elemental calcium. That is why Cal20 is different. There are no compounds in Cal20 that the body needs to breakdown before accessing the elemental calcium. This is why Cal20 is near 100% bioavailable.
  3. Standard calcium salt supplements available in the market generally also have low absorption rates due to their bonding with phytic acid found in food. When calcium bonds with phytic acid in the gut, it prohibits the body from absorbing it. However, Cal20, a probiotic infused calcium supplement, improves this situation significantly. The probiotics in Cal20 interact with phytic acid, preventing it from bonding with calcium. This interruption allows for enhanced calcium release and absorption, thus alleviating issues such as calcium induced constipation and lactose malabsorption. Essentially, Cal20’s probiotic infusion leads to significantly better calcium bioavailability compared to traditional calcium salts.
  4. Cal20 is free of salts so it doesn’t contribute to common issues often associated with common calcium supplements, such as gastric irritation and constipation. This makes Cal20 an excellent choice for those seeking to support bone health without the unwanted side effects of common calcium.
  5. Cal20 is not just a source of calcium; it also delivers essential elements like phosphorus, magnesium, potassium and vitamin D3, along with soy isoflavones and probiotics.
  6. Cal20 provides the required ratio of calcium to phosphorus (2:1), the same ratio found in human bones. Calcium and phosphorus are the two primary minerals that constitute the bulk of our bones and teeth. Together, they form a compound known as hydroxyapatite, which provides the rigidity, density, and structure that bones need to support the body and protect vital organs. If we think of our bones as a concrete building, just as concrete is a mixture of cement, sand, and water, the structure of human bones is made up of several components. The ‘cement’ of the human bone is primarily the hydroxyapatite crystals, formed from calcium and phosphorus.
  7. The inclusion of Vitamin D3, aids the human body further in absorbing the calcium into the bones.
  8. The soy isoflavones have shown to aid in waking up the osteoblasts, which are a key mechanism for building bones.

Calcium carbonate is a common substance found in rocks as the mineral’s calcite and aragonite (most notably as limestone, which is a type of sedimentary rock consisting mainly of calcite) and is the main component of eggshells, snail shells, seashells and pearls. Calcium carbonate is the active ingredient in agricultural lime and is created when calcium ions in hard water react with carbonate ions to create limescale. It has medical use as a calcium supplement and as an antacid, but excessive consumption can be hazardous and cause poor digestion, constipation, and heartburn.

  • Calcium Carbonate has poor absorption in the body because the carbonate needs stomach acid (an acidic medium) to be absorbed and its simultaneous properties as an antacid hinder this, which is why only 2% of it is absorbed by the body vs the near 100% absorption rate of Cal20.
  • Long term use of Calcium Carbonate leads to unwanted side effects such as kidney stones and calcification.

Currently we are formulating and marketing Cal20 in a tablet form only due to its convivence and ease of use, however different dosage forms are being developed.

Optional dosages:

Long term maintenance/preventative dose: 1 tablet per day

Therapeutic dosages range from 2x once a day to 2x tablets twice a day to treat severe osteoporosis in the first 2 to 6 months.  When pain-related osteoporosis symptoms subside the dose is then reduced to 2 a day. Once a comfortable bone density is achieved, we suggest moving to 1 a day as a long term maintenance dose.

Ideally Cal20 should be taken 1 hour before or 2 hours after a meal within the first half of the day. If this is not possible, anytime in the morning is good.

We have seen the reversal of Osteoporosis to Osteopenia in many patients taking 4 a day within the 6 month period. We have seen these amazing results too in patients taking 2 a day for 12 months to 2 years. What is clear is the strength trajectory of nearly all our patients’ bones changes from getting weaker without Cal20 to getting stronger over time with Cal20.

Studies conducted in the USA and India saw remarkable improvements in bone density and the alleviation of symptoms associated with Osteoporosis in over 85% of the participants. There are a number of Clinical studies available to read:  “Efficacy of Cal20 in post menopausal females” and “Clinical Study of Bioavailable Calcium-Probiotics”. For a top line view of all the studies which support Cal20, have a look at “Summary of three published Clinical Trials” We also recommend watching this interview with Lindy Botha who no longer has Osteoporosis after taking Cal20 for over a 2 year period.

Our approach involves the utilization of calcium in its natural elemental form, along with other components that promote calcium absorption. The co-administration of phosphorus, magnesium, potassium, probiotics, soy isoflavones and vitamin D3 with calcium, increases Cal20’s uptake in the body through the transcellular mechanism, a process that allows direct passage of calcium into cells.

Minerals extracted from dairy milk tend to be more bioavailable and are readily used by the body due to several reasons:

  • They contain high levels of calcium.
  • They contain the supporting minerals that assist in the body in the absorption of calcium.
  • They maintain an optimal calcium to phosphorus ratio of 2:1, which is ideal for bioavailability and the creation of hydroxyapatite crystals that acts like the cement that makes bones strong.
  • The dairy source provides minor milk minerals and peptides that aid in the absorption of calcium and its deposition into tissues.
  • After the extraction process from milk, it contains a reduced amount of lactose which helps facilitate calcium absorption without triggering lactose intolerance.

With the addition of probiotics in Cal20, further benefits are seen including:

  • Increase in the absorption of calcium and vitamin D3
  • Enhancement of bone mineralization by promoting an acidic environment in the small intestine, which further aids in the absorption of minerals by increasing their solubility.
  • Phytates, substances found in plant based foods, can interfere with mineral absorption by turning minerals into a form that is not soluble. On the other hand, probiotics produce enzymes known as phytases. These phytases neutralize the effect of phytic acid, helping to keep minerals in a form that is soluble and, therefore, available for the body to absorb.
  • The probiotics supply lactase enzymes, which help to counteract lactose intolerance in individuals who are sensitive to it. In addition, probiotics generate short-chain fatty acids (SCFAs) such as butyrate, propionate, and acetate within the large intestine. These SCFAs improve the capacity of the cells in the colon, known as colonocytes, to absorb minerals, thereby leading to an overall increase in the body’s ability to absorb the minerals in Cal20.

The Soy isoflavones has shown to help bone health in several ways:

  • Mimicking Estrogen: Since they have a similar structure to estrogen, isoflavones can bind to estrogen receptors in the body, including those in bones. This is particularly beneficial during menopause, a time when the body’s natural estrogen levels drop and bone loss can accelerate. By binding to these receptors, isoflavones can help to reduce the rate of bone loss and enhance bone mineral density.
  • Antioxidant Properties: Isoflavones are also antioxidants, which means they can combat free radicals in the body. Free radicals can damage the body’s cells, including bone cells, and contribute to various diseases and conditions, including osteoporosis. By neutralizing free radicals, the antioxidant action of isoflavones can help to protect bone cells from damage.
  • Regulating Bone Remodeling: Research suggests that isoflavones may also play a role stimulating the osteoblasts to wake up and get to work building healthy bone. They also regulate the balance between bone-building cells (osteoblasts) and bone-breaking down cells (osteoclasts). This regulation helps maintain a healthy bone remodelling process, which is critical for preserving bone strength.

The addition of Vitamin D3 has shown to help bone health in several ways:

  • Vitamin D3 enhances the absorption of calcium and phosphorous in the small intestine. Without sufficient Vitamin D, much of the dietary calcium and phosphorous would pass through the body unused.
  • Vitamin D3 also helps regulate the process of bone remodelling, which is a balance between the breakdown of old bone (bone resorption by osteoclasts) and the formation of new bone (by osteoblasts). When Vitamin D levels are adequate, this process remains in balance. However, a deficiency of Vitamin D can lead to excessive bone resorption, where the breakdown of bone occurs at a faster rate than the formation of new bone.

Cal20 is characterized by a high safety profile. The calcium used in Cal20 is in an ionized form, which reduces the likelihood of side effects such as gastric irritation and constipation, typically associated with other forms of calcium.

Moreover, Cal20 is derived from a natural, vegetarian source, which makes it safe for consumption with no added fillers or toxins. Cal20’s safety is often referred to that of mother’s milk for children.

Additionally, the World Health Organization (WHO) has granted Generally Recognized as Safe (GRAS) status to probiotics, a key component in our formulation. Therefore, our product is regarded as completely safe for use. Cal20 also has FDA, ISO and WHO certification.

Cal20 is generally considered safe for individuals who are lactose intolerant. Cal20 is a calcium-rich mineral complex derived from milk, and the extraction process leaves behind only a very small amounts of lactose. Given these small quantities and the addition of probiotics to the tablet (which help efficiently digest any residual lactose), the likelihood of experiencing symptoms of lactose intolerance is significantly reduced.

To date, there have been no reported instances of lactose intolerance related to Cal20. If you have concerns, we recommend starting with a single tablet and monitoring for any intolerance symptoms over the next 24-48 hours. If symptoms do arise, we advise discontinuing the use of Cal20, otherwise continue as advised by your healthcare provider.

Cal20 contains a small amount of soy isoflavones, which are dietary supplements derived from soybeans and include phytoestrogen isoflavones. The way these isoflavones work isn’t completely understood, but they appear to mimic the actions of estrogen through estrogen receptors. They also seem to influence estrogen metabolism. As a result, soy isoflavones have demonstrated the ability to decrease cell proliferation and increase cell apoptosis (natural cell death) as well as regulate hormone balance, thus potentially reducing the risks of conditions like breast cancer, heart disease, and osteoporosis.

Even though the soy isoflavones in Cal20 are sourced from soybeans, they are not the same as consuming whole soybeans or soy milk. They should not trigger soy allergies. To date, there have been NO reported allergic reactions related to Cal20. If you have concerns, we recommend starting with a single tablet and monitoring for any intolerance symptoms over the next 24 to 72 hours. If symptoms do arise, we advise discontinuing the use of Cal20, otherwise continue as advised by your healthcare provider.

The soy isoflavones stimulate the bone osteoblasts to wake up and get to work building bone. They have also shown the benefit of reducing symptoms associated with menopause such as hot flushes.

The ability of soy isoflavones to decrease cell proliferation and increase cell apoptosis can be seen as a beneficial effect in certain contexts. Here are a few reasons why this may be considered advantageous:

  1. Cancer Prevention: Uncontrolled cell proliferation is a hallmark of cancer. By inhibiting excessive cell growth and promoting cell death, soy isoflavones may help reduce the risk of certain types of cancer or slow down the progression of cancer cells. Research suggests that soy isoflavones, such as genistein, exhibit anti-cancer properties by interfering with signaling pathways involved in cell proliferation and survival.
  2. Hormone-Related Conditions: Soy isoflavones have estrogen-like properties and are classified as phytoestrogens. In conditions influenced by hormones, such as breast and prostate cancer, menopausal symptoms, and osteoporosis, the ability of soy isoflavones to modulate cell proliferation and promote cell death may provide therapeutic benefits.
  3. Cardiovascular Health: Increased cell proliferation can contribute to the development of atherosclerosis, a condition characterized by plaque buildup in the arteries. By reducing cell proliferation and promoting cell death, soy isoflavones may help protect against cardiovascular diseases and maintain heart health.
  4. Anti-Inflammatory Effects: Excessive cell proliferation and impaired cell death processes can contribute to chronic inflammation. By modulating these cellular processes, soy isoflavones may exert anti-inflammatory effects, helping to mitigate the inflammatory response associated with various diseases.

However, it is important to note that the effects of soy isoflavones can vary depending on the dosage, duration of exposure, individual characteristics, and specific health conditions. As with any dietary component or supplement, it is advisable to consult with a healthcare professional for personalized advice and to ensure that it aligns with your specific health circumstances.

By comparison, especially considering common side effects like gas, constipation, and bloating, often associated with these salts, Cal20 is a superior product for the following reasons:

Calcium Citrate: This is a chelated mineral, which essentially means its calcium carbonate encapsulated in a citric acid-derived coating. It typically provides less elemental calcium per pill, which might require consumers to take more pills daily, depending on their needs, which then results in the side effects noted above. Notably, those with acid reflux may not tolerate calcium citrate well.

Calcium Gluconate and Calcium Lactate: These forms of calcium supplements contain a low percentage of elemental calcium. Specifically, calcium gluconate is only 9.3% calcium, while calcium lactate is about 13% calcium. Consequently, to meet daily calcium requirements, one may need to consume a substantial number of these tablets, potentially leading to side effects like gas and constipation. Cal20 has no such side effects.

Calcium Carbonate: This is a major constituent of substances like limestone, chalk, marble, pearls, and corals. However, questions arise regarding the purity of supplements made from this source and the body’s ability to utilize the calcium derived from such large molecules. The calcium particle size in Cal20 is is less than 40 microns which is excellent for bioabsorption. Calcium carbonate is the active ingredient in agricultural lime and is created when calcium ions in hard water react with carbonate ions to create limescale. It has medical uses as a calcium supplement and as an antacid, but excessive consumption can be hazardous and cause poor digestion.

  1. Calcium Carbonate has poor absorption in the body because the carbonate needs stomach acid to be absorbed.
  2. Calcium Carbonate depends on an acidic medium for absorption, but it acts as an antacid which neutralises the acidic medium of the stomach. This renders the bioavailability the calcium portion of the supplement as extremely poor.
  3. Long term use of Calcium Carbonate leads to unwanted side effects such as kidney stones and calcification.
  4. The average human being can only absorb 2% of the calcium in calcium carbonate.

Cal20 contains 200iu of vitamin D3 per tablet.

The probiotics in Cal20 play a significant role in mitigating common issues such as calcium induced constipation and lactose malabsorption. Phytic acid, found in various foods, can bind with calcium, which prevents it from being absorbed and made available to the body. The probiotic bacteria in Cal20 helps absorption by inhibiting this bond between phytic acid and calcium in the intestine. This allows calcium to be released and thus significantly improves its bioavailability.

Natural dairy milk calcium – Cal20 Other calcium salts like Calcium Carbonate/Citrate
Highly bioavailable Poorly bioavailable
It is in elemental, ionic, form = great for absorption It is in salt form  = hard for the body to absorb
No gastric irritation, No constipation. Causes Gastric irritation and Constipation.

The calcium in Cal20 is in an elemental, or ionic form, which allows for nearly 100% direct absorption by the body. Calcium functions similarly to other nutritional supplements such as amino acids, minerals, and glucose, in that there isn’t a direct mechanism for nutrient delivery to cells.

Dietary calcium is absorbed in the gastrointestinal (GI) tract at three main locations:

  1. Duodenum and Proximal Part of Jejunum: The duodenum is the first section of the small intestine immediately following the stomach, and the jejunum is the next section. Together, they kick off the process of calcium absorption.
  2. Distal Part of Jejunum and Ileum: The distal (or lower) part of the jejunum and the ileum, which is the final part of the small intestine, continue the absorption process initiated by the duodenum and proximal jejunum.
  3. Caecum and Ascending Colon: These are parts of the large intestine where some calcium absorption occurs, though to a lesser extent compared to the small intestine.

Most of the elemental calcium in Cal20 is absorbed through a process known as the transcellular mechanism. This active transport system depends on the presence of vitamin D, phosphorus, and magnesium. In essence, this means these substances work together to facilitate the absorption of calcium into the body, making it available for various physiological processes. All these elements are present in 1 Cal20 tablet.

Distribution: Calcium is essential for a variety of biological functions, existing either as a free ion or within bound complexes. One of its crucial roles is in skeletal mineralization, where it exists as bound calcium. Over 99% of the body’s total calcium is in the skeleton as calcium-phosphate complexes (predominantly as hydroxyapatite) which imparts significant material properties to bone. Within the bone structure, calcium serves a dual purpose: it enhances skeletal strength and simultaneously acts as a dynamic reservoir, keeping a supply of calcium ready to be used to maintain the right levels of calcium inside and outside of our cells.

Metabolism: The cornerstone of calcium metabolism is plasma calcium homeostasis, a mechanism that regulates the concentration of calcium ions in blood plasma within very narrow boundaries. To be bioavailable, ionized calcium should not precipitate when mixed with bile and pancreatic juice, which alkalize the stomach contents. Therefore, bioavailable calcium must be soluble, ionized, and importantly, remain non-precipitating at an alkaline pH in the duodenum. Cal20’s achieves this requirement.