diff --git a/backend/src/db/client.ts b/backend/src/db/client.ts
index cefc424..6870438 100644
--- a/backend/src/db/client.ts
+++ b/backend/src/db/client.ts
@@ -24,12 +24,114 @@ export const db = drizzle(client);
 
 // Auto-run migrations (self-healing database)
 async function runMigrations() {
+  // First, ensure all tables exist (for fresh databases)
+  const tableCreations = [
+    `CREATE TABLE IF NOT EXISTS users (
+      id integer PRIMARY KEY AUTOINCREMENT,
+      username text NOT NULL UNIQUE,
+      password_hash text,
+      email text,
+      auth_provider text NOT NULL DEFAULT 'local',
+      is_active integer NOT NULL DEFAULT 1,
+      last_login_at integer,
+      created_at integer NOT NULL DEFAULT (strftime('%s','now')),
+      updated_at integer NOT NULL DEFAULT (strftime('%s','now'))
+    )`,
+    `CREATE TABLE IF NOT EXISTS medications (
+      id integer PRIMARY KEY AUTOINCREMENT,
+      user_id integer NOT NULL,
+      name text NOT NULL,
+      generic_name text,
+      taken_by text,
+      count integer NOT NULL DEFAULT 0,
+      strips integer NOT NULL DEFAULT 0,
+      pack_count integer NOT NULL DEFAULT 1,
+      strips_per_pack integer NOT NULL DEFAULT 1,
+      tabs_per_strip integer NOT NULL DEFAULT 1,
+      loose_tablets integer NOT NULL DEFAULT 0,
+      pill_weight_mg integer,
+      usage_json text NOT NULL DEFAULT '[]',
+      every_json text NOT NULL DEFAULT '[]',
+      start_json text NOT NULL DEFAULT '[]',
+      strip_size integer NOT NULL DEFAULT 1,
+      image_url text,
+      expiry_date text,
+      notes text,
+      intake_reminders_enabled integer NOT NULL DEFAULT 0,
+      updated_at integer NOT NULL DEFAULT (strftime('%s','now')),
+      FOREIGN KEY (user_id) REFERENCES users(id) ON DELETE CASCADE
+    )`,
+    `CREATE TABLE IF NOT EXISTS user_settings (
+      id integer PRIMARY KEY AUTOINCREMENT,
+      user_id integer NOT NULL UNIQUE,
+      email_enabled integer NOT NULL DEFAULT 0,
+      notification_email text,
+      email_stock_reminders integer NOT NULL DEFAULT 1,
+      email_intake_reminders integer NOT NULL DEFAULT 1,
+      shoutrrr_enabled integer NOT NULL DEFAULT 0,
+      shoutrrr_url text,
+      shoutrrr_stock_reminders integer NOT NULL DEFAULT 1,
+      shoutrrr_intake_reminders integer NOT NULL DEFAULT 1,
+      reminder_days_before integer NOT NULL DEFAULT 7,
+      repeat_daily_reminders integer NOT NULL DEFAULT 0,
+      low_stock_days integer NOT NULL DEFAULT 30,
+      normal_stock_days integer NOT NULL DEFAULT 90,
+      high_stock_days integer NOT NULL DEFAULT 180,
+      expiry_warning_days integer NOT NULL DEFAULT 90,
+      language text NOT NULL DEFAULT 'en',
+      last_auto_email_sent text,
+      last_notification_type text,
+      last_notification_channel text,
+      updated_at integer NOT NULL DEFAULT (strftime('%s','now')),
+      FOREIGN KEY (user_id) REFERENCES users(id) ON DELETE CASCADE
+    )`,
+    `CREATE TABLE IF NOT EXISTS refresh_tokens (
+      id integer PRIMARY KEY AUTOINCREMENT,
+      user_id integer NOT NULL,
+      token_id text NOT NULL UNIQUE,
+      expires_at integer NOT NULL,
+      rotated_at integer,
+      revoked integer NOT NULL DEFAULT 0,
+      created_at integer NOT NULL DEFAULT (strftime('%s','now')),
+      FOREIGN KEY (user_id) REFERENCES users(id) ON DELETE CASCADE
+    )`,
+    `CREATE TABLE IF NOT EXISTS share_tokens (
+      id integer PRIMARY KEY AUTOINCREMENT,
+      user_id integer NOT NULL,
+      token text NOT NULL UNIQUE,
+      taken_by text NOT NULL,
+      schedule_days integer NOT NULL DEFAULT 30,
+      created_at integer NOT NULL DEFAULT (strftime('%s','now')),
+      FOREIGN KEY (user_id) REFERENCES users(id) ON DELETE CASCADE
+    )`,
+    `CREATE TABLE IF NOT EXISTS dose_tracking (
+      id integer PRIMARY KEY AUTOINCREMENT,
+      user_id integer NOT NULL,
+      dose_id text NOT NULL,
+      taken_at integer NOT NULL DEFAULT (strftime('%s','now')),
+      marked_by text,
+      FOREIGN KEY (user_id) REFERENCES users(id) ON DELETE CASCADE
+    )`,
+  ];
+
+  for (const sql of tableCreations) {
+    try {
+      await client.execute(sql);
+    } catch (e: any) {
+      console.error(`[DB] Table creation error:`, e.message);
+    }
+  }
+  console.log(`[DB] Tables verified/created`);
+
+  // Then run column migrations for existing databases
   const migrations = [
     { name: "image_url", sql: "ALTER TABLE medications ADD COLUMN image_url TEXT" },
     { name: "expiry_date", sql: "ALTER TABLE medications ADD COLUMN expiry_date TEXT" },
     { name: "notes", sql: "ALTER TABLE medications ADD COLUMN notes TEXT" },
     { name: "generic_name", sql: "ALTER TABLE medications ADD COLUMN generic_name TEXT" },
     { name: "intake_reminders_enabled", sql: "ALTER TABLE medications ADD COLUMN intake_reminders_enabled INTEGER NOT NULL DEFAULT 0" },
+    { name: "users_email", sql: "ALTER TABLE users ADD COLUMN email TEXT" },
+    { name: "user_settings_expiry_warning_days", sql: "ALTER TABLE user_settings ADD COLUMN expiry_warning_days INTEGER NOT NULL DEFAULT 90" },
   ];
 
   for (const migration of migrations) {