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MCT8 deficiency (Allan-Herndon-Dudley syndrome) is a rare X-linked genetic disorder that causes profound neurodevelopmental delay, movement disorders, and peripheral thyrotoxicosis secondary to elevated serum tri-iodothyronine. The condition is chronic and life-limiting, with patients requiring regular multidisciplinary monitoring to manage their symptoms. This guideline proposes a comprehensive, multidisciplinary management strategy for healthcare professionals caring for patients with MCT8 deficiency across all age groups, monitoring key symptoms and sequelae. 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