This is a question I hear often in clinic, and the honest answer has more nuance than a one-line rule.
Panchakarma is not a single treatment but a structured sequence: preparatory therapies (poorvakarma) to loosen deep-seated toxins, the main procedures (pradhanakarma) themselves, and a supervised recovery phase (paschatkarma) that is just as clinically important as the procedures. Skipping or compressing any of these three stages is where most poor outcomes come from.
In my practice, I assess dosha predominance, digestive strength (agni), and the specific tissue depth a condition has reached before recommending a protocol. Two patients with the same complaint can need meaningfully different treatment sequences.
The classical texts are specific about contraindications and timing, and a properly trained physician follows them closely rather than applying a generic package regardless of the patient in front of them.
Every patient's presentation is different, so this is general clinical guidance rather than a substitute for an individual consultation — Testing, Testing, would want to examine your specific history before recommending a protocol.