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5. Making whoopee can pay. If your doctor prescribes sex therapy, the cost can be deducted as a medical expense, says Lyons. Unfortunately, the IRS won't let you write off a health club membership, even if your doctor and spouse agree that you need to go to a gym.

Taxpayers have obviously tried to write off many healthful activities. In one celebrated tax law case, the cost of clarinet lessons was ruled to be an acceptable deduction, after an orthodontist recommended that a child learn the instrument to correct a severe overbite.

But the IRS has rejected many unorthodox medical expenses. H&R Block lists the following:

Dancing lessons: A 1964 ruling disallowed dance lessons as a medical expense to improve varicose veins. A later ruling disallowed dancing as a medical expense to ease arthritis and nervous conditions.

Diaper services: "Very convenient, but not an allowable medical deduction," H&R Block says.
Salad: The cost of lettuce and tomato not deductible as medical expense for a diabetic on a restricted diet, according to a 1966 court ruling. The same taxpayer also tried to deduct artificial sweeteners and reduced-salt foods. He was likewise denied.
A fallout shelter: Useful in a nuclear war, but not deductible as "preventive medicine."

6. Legitimate expenses of illegitimate businesses: If you're selling marijuana and cocaine, you can deduct legitimate business expenses. That would include paper clips and office supplies, baggies to package the merchandise, and so forth.

"Just remember, the IRS expects you to declare all your illegal drug income," says Miami-based forensic accountant Stanley Foodman. "Once you're busted, there are tax ramifications."

Illegitimate business expenses — smuggling contraband, kickbacks to rogue law enforcement officers, etc. — can't be deducted.

Foodman says he's actually had clients who've listed illegal businesses on their tax returns. One woman described her occupation as "prostitute."

"She wanted to declare all her income and set up a retirement plan," Foodman says. "She was very up-front about how she earned her money."