Feeling tired, cold, bloated, even forgetful? You might have an underactive thyroid and not even know it.

Though roughly 20 million Americans suffer from some sort of thyroid disease, 60% of them have no idea. The symptoms of hypothyroidism in particular (e.g. weight gain, fatigue) can be easily misdiagnosed — and even blood tests are pretty ineffective.

And like all autoimmune diseases, hypothyroidism disproportionately affects women.

"I struggle with my weight, even in times when I eat a healthy diet and work out daily," Melanie Smith, 42, told Revelist. But as I have gotten older, the exhaustion [is a concern]."

"I don't mean a little tired — I am talking periods of time when walking up the stairs is more energy than I have."

In addition to their daily hurdles with fatigue and other symptoms, women with hypothyroidism are more likely to miscarry and have children with developmental issues.

Above all, women with hypothyroid are warriors. Here's a glimpse into what it's like to live with the disease:

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When you get a good report from your dr. 7lbs down!! #hypothyroidismsucks

A photo posted by Jessica (@jezzika_renee) on

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"Having hypothyroidism is hard enough because of the physical toll it takes on you — for me, that includes constant fatigue, weight gain, anxiety, muscle aches, loss of libido and even short term memory loss — but also because of the emotional toll is takes. I've forgotten the simplest things during job interviews and constantly worry about my weight and it's so hard to communicate that it's because of the disease to people who can't see or feel what you do."

"Just because I look okay, or my symptoms are kinda all over the place, doesn't mean I'm using it as an excuse." — Mandy Velez, 25

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