Blown head gasket

Good evening.

If you are using water and not leaking then it very well may be a failed head gasket.

Does the truck smoke out the tail pipe?

The cylinder head will have to be removed and inspected for cracks and for being warped.

Will you be attempting this job yourself or will you have a shop perform this repair?

Roy

https://www.2carpros.com/articles/head-gasket-blown-test