My discussion below is based on experience with the 3.5 engine, but could you clarify if you have that one or the 3.3?
Yes, it's possible that any one of the causes of overheating could end up tweaking the block/head interface and leaking from that head gasket area.
Some overheating causes are:
- Thermostat
- Water control valve (rear thermostat)
- Accessory belt system
- Water pump
- Radiator fan shroud
- Cooling fan clutch
- Cooling fan blades
- Radiator. Cracking plastic or the metal crimp coming apart
- Radiator cap
- Head gasket. Which is technically a result of overheating...unless the head gasket has already been worked on.
- Other coolant leaks, which includes weak or damaged hoses
Of those, the ones I would focus most in an R50 are the cooling fan blades, radiator, cap, water pump seals.
In my experience, a properly working radiator and cap will not be damaged by a bad head gasket; however the reverse is very likely.
Anecdotal
I had a 2002 Qx4 with 313,000 miles and an original radiator. However, it does not surprise me to have to replace a 2000-2006 era Calsonic radiator when the vehicle has approx 150K miles. It was a weird time for Nissan radiators.
At the same time, I had another Qx4 that constantly overheated, but we came to find out that whoever had replaced the engine the first time had done a crap job of keeping the head and block surfaces smooth while rebuilding it.
*Oh, that radiator was good and was used when the engine was replaced.
Most times I prefer buying a warrantied engine to rebuilding a damaged engine.
Problem vs. Symptoms
All along, it does not seem like the source of the leak has been identified. I assume it's external, right?
There is another possibility. On the rear surface of the heads, there is a
crossover tube that might leak right where the ends mate to the heads.
My recommendation is to test it again, whether yourself or a different shop. I mean the thing has already overheated and thrown up, right?
Drive the vehicle long enough to warm it up then leave it running in park and when coolant starts to drip, look in the engine bay (remember the back side of the heads).
P.S. The engine heats up way faster with the cooling fan decoupled, but I'd only recommend it for brave hearts.
OR
Put some UV dye in the system and when it leaks, trace the source. UV tracer kits can be had for cheap from most auto parts stores
P.S. I usually run distilled water in testing. Coolant can get expensive, especially if it keeps leaking out; but that is personal preference.
OR
Have them (or yourself, or other shop) use a pressure test kit to try and find the leak.
The testing might show some interesting results.
I'm not saying that you certainly don't have a bad head gasket, but I would sure gamble another $50 in testing if it has the potential to save me $4000+
At this point, I think the shop's proposals are akin to burning your house down when you see a spider in your bedroom. Yeah, the problem will go away, but in the end you wonder if you could have achieved the same result with less disruption.