The phrase "takes its toll" refers to the negative consequences that arise from a particular action or circumstance. Some synonyms for this expression include "wears away," "erodes," "diminishes," "depletes," and "weakens." Other words that capture the sense of the phrase include "exhaustion," "fatigue," "weariness," and "drain." "Takes its toll" may also be replaced by "has an impact," "causes harm," "results in a cost," or "takes a heavy burden." These synonyms are useful in adding variety and depth to one's writing and in avoiding repetition. In any case, the phrase "takes its toll" remains a poignant reminder of the consequences of our choices and actions.