I am also trying to change the twain setting to allow black and white.
A big downside to large pdf files is difficulty emailing and slower interfacing with any program requiring frequent document uploading e.g. UpDox.
Sending these documents over the internet is visibly sluggish - I am unable to email some charts due to size - printing is slower, email faxing is slower, my day is slower as i use UpDox to fax many documents previously scanned.
I would love Updox if it were faster - it is slow due to my file sizes.
I hope someone comes up with a way within TWAIN to do this... is should be simple... I'll keep looking.