In my last truck (1996 5 speed with a #11 full forward), I was getting hot (1300 or so) while towing between 5000 feet, and 10,000 feet. I installed a HT turbo stage 3 compressor wheel and housing, and it solves my high EGT problems.
PSIA = PSI Absolute
PSIG = PSI Gauge
PSIA = atmospheric pressure plus gauge pressure
Pressure ratio = output pressure/input pressure
At lower altitudes, the compressor upgrade alone may not help too much, but at high altitudes it seems to work very well. At higher altitudes, you are starting out with lower atmospheric pressure than you are at sea level. Roughly 12 PSIA at 5500 feet versus 14. 7 PSIA at sea level. So in order for a turbo to generate 30 PSIG at 5500 feet, it has to create a pressure ratio of (30+12)/12 = 3. 5. For that same turbo to generate 30 psig at sea level, it onlt has to create a pressure ratio of (30+14. 7)/14. 7 = 3. 04. The mass flow rate is very slightly higher for the turbo at sea level (because 30 psig is 44. 7 psia at sea level and only 42 psia at 5500 feet), but basically identical to mass flow rate through the turbo at 5500 feet in that example, so therefore the exhaust housing size does not need to be increased, howerer the compressor houssing and wheel need to produce a higher pressure ratio, and therefore they need to be larger.