What rpm are you running at 40-45mph? What happens when you turn the over drive off?
At 40-45, in OD your probably running about 14-1500rpm, kinda lugging it.
Turning the OD off will jump the RPM's up, but you will run same speed, but your tires are rotating the same speed. If it still shudders, I would def go for a tire issue.
But if it smooths out, I would look towards a fuel delivery issue.
Been there done that. My truck could shake you fillings out at 40-45 mph. Turm off OD, raing the rpms and no shudder. After a lot testing and checking, MY problem were injectors. I changed them out and not a problem since.
There is an old thread from me on www.ford-trucks.com. Along with a lot of other info.
Good luck, Ken