03 rough idle sometimes

[killa071]

Have an 03 with a 6.0 223000 miles auto trans egr delete new headgaskets and studs after driving it sometimes it will idle rough and on start up it starts kinda funny sounds like a couple injectors don't fire right away but after 3 seconds or so it's fine any ideas??

[Big Angry Hillbilly]

Is it cold there?

If it's just idling ratty on cold starts, you probably have a couple injectors with scored/sticking spool valves.

If it's running ratty while driving, I'd suspect you probably have a leaking ICP sensor, if it's an early build truck (ICP under turbo). See if it's leaking oil.

Could also be a FICM, fuel pressure, HP oil system concern, oil quality concern....the list goes on and on.