I would only consider a gearing change if you find yourself shifting down TWO gears frequently. If you normally only drop out of OD into direct, then I wouldn't worry about it at all.
Switching to a 4.10, 4.30, or taller gear will not magically allow you to fly up mountain passes at 75MPH turning 1500RPM.
Quite the opposite will happen. Your engine will turn higher RPMs in ***ALL*** gears. If you go far enough with your gearing change it will be the equivalent of simply shifting down one gear in the transmission.
The gearing change will simply allow you to hold OD for a few more seconds in the mountain passes, but when you shift down the truck will be roaring even LOUDER to maintain the same speed as before.