In a large skillet over medium heat, add the oil. Once the oil is hot, add the onion, garlic and ginger and cook for about 3 minutes or until beginning to soften and lightly browned. Then add the carrots and mushrooms and cook for an additional 3 minutes.
Next add the ground turkey, crumbling with a wooden spatula, until browned, about 6 minutes.
Once the meat is cooked, add the coconut aminos, fish sauce, sesame oil, lime juice, spinach and coconut sugar, if using. Stir together and increase the heat to medium high and let the mixture come to a boil. Continue to reduce the sauce for about 2-3 minutes until most of the sauce is gone.
Remove from the heat, add the scallions, cilantro and additional lime juice, if desired and season with salt and pepper to taste.
Serve in the lettuce cups and top with hoisin sauce if desired and enjoy!