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Re: Truck vibrating, loss of fuel efficiency
Very well possible that it is ignition related rather than fuel injectors. I would replace the distributor cap and rotor. I recently had on that was having pretty much the same problem as you are describing and that took care of it. I am presuming that it is not a diesel.
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check engine mounts especially the rear box mount because under high torque situations (1-2) gears there may be mis-alignment of the drive shaft occurring and the vibration is from "U" joints behind the gear box getting out of alignment and phase angle.. Check slip joints for lubrication and wear.
sounds like you are losing pressure could be the exhaust or the piston rings or the head manifold leaking. if you have the engine pressure tested should tell you witch is the problem rings is mostly the problem on a work hourse engine. .
One of the plug wires may be arching or have a defective spark. It's odd, but I check mine by removing each plug wire one at a time. I'll use stick the end of a screw driver (insulated handle) in the plug wire and check the spark coming in from the coil/coil pack/distributor. Keep in mind, the engine is running and I only do this if there's no shop open or close by. Also the insulated handles are for that unwanted shock. Has he checked for sparks at night with the engine running. Look around and follow the plug wires and around coil/coil pack for any jumping sparks. If any are seen, there's your problem.
I'm having the same problem with my 90 2.3L Ranger. I replaced the EGR Valve back in August and the truck ran fine (but the gas mileage was bad) until late December . I knew it needed an O2 Sensor back in August but didn't replace it until last Saturday along with the Idle Air Control Valve, Plugs and Wires. The truck ran fine for a couple minutes then started running like a VW bug! My code reader is now throwing out an EGR failure code, so I guess i'll take the 4 month EGR back and get a new one, and see what that does!