The phrase "blood sweat and tears" is often used to describe the intense effort and hard work required to achieve something. However, there are several synonyms that can be used in place of this phrase. For example, "grit and determination" are commonly used to denote resilience and perseverance. "Hard graft" is another term that refers to the tireless effort required to attain a goal. "Putting in the work" and "burning the midnight oil" both highlight the dedication and sacrifice required to succeed. Whatever the term used, it's clear that success typically requires a great deal of effort and sacrifice.