In a large sauce pan (I used our Dutch oven), add turkey sausage, shallot, garlic and onion. Add a little bit of the red pepper flakes and Italian seasoning.
After it’s thoroughly cooked, add in tomatoes, bone broth and seasonings. (This is where I taste until I get the desired flavor! I added quite a bit of garlic, red pepper flakes and Italian seasoning. - salt amount will depend on type of broth used). Cover and let simmer for 10-15 minutes.
Add in the spinach and tortellini, stir and bring to a boil. Add in cottage cheese and stir until well combined and the spinach is wilted.
Top with Parmesan cheese and enjoy!