My 89 4Runner has a 22RE with a mid range cam and essentially stock exhaust on 35 inch tires and 4.88 gears. It turns them just fine, but I live at sealevel. Crankycrawler also runs 35 inch tires on his 84 truck with 4.88 gears in Colorado. His engine is pretty much stock if I remember correctly.
If you get the wrong header you won't ever see a real difference. Headers can improve air flow but generally the performance inprovement is at very high rpm. This why you see long tube headers on muscle cars, the longer the header the lower the rpm that it benefits. If you're running a header I wouldn't expect a mid range cam to be a good match to maximize on the combination.
I think 5.29s should do great.
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