I have a tow/haul switch, but am appreciative of the advice to use the S shifter and tow/haul combination. Keep it in 4th on the grades with tow switch on.
I keep it in S5 when towing, shouldn't need 4th unless it is very hilly up and down causing it to shift back and forth between gears. In S5 it will lock out 6th (overdrive) but still shift normally between 1st and 5th. Use tow mode and let the computer do its job to shift for optimal performance.
As for the down hills, the Tundra has sensors built in to downshift and engine brake as needed. It works pretty good to hold speed but on some steeper hills you may need to manually drop another gear.